Provider Demographics
NPI:1811948045
Name:ISLAND AUDIOLOGY, LLC
Entity type:Organization
Organization Name:ISLAND AUDIOLOGY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:C
Authorized Official - Last Name:WIELINS
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:808-955-4327
Mailing Address - Street 1:1601 KAPIOLANI BLVD STE 950
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-4700
Mailing Address - Country:US
Mailing Address - Phone:808-955-4327
Mailing Address - Fax:808-589-2311
Practice Address - Street 1:1601 KAPIOLANI BLVD STE 950
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-4700
Practice Address - Country:US
Practice Address - Phone:808-955-4327
Practice Address - Fax:808-589-2311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-12
Last Update Date:2018-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAUD97231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty