Provider Demographics
NPI:1831865179
Name:KEITH, BRITTNEY J (PSYD)
Entity type:Individual
Prefix:DR
First Name:BRITTNEY
Middle Name:J
Last Name:KEITH
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 130
Mailing Address - Street 2:
Mailing Address - City:KAUNAKAKAI
Mailing Address - State:HI
Mailing Address - Zip Code:96748-0130
Mailing Address - Country:US
Mailing Address - Phone:808-560-3653
Mailing Address - Fax:
Practice Address - Street 1:604 MAUNALOA HWY.
Practice Address - Street 2:BLDG C
Practice Address - City:KAUNAKAKAI
Practice Address - State:HI
Practice Address - Zip Code:96748
Practice Address - Country:US
Practice Address - Phone:808-560-3653
Practice Address - Fax:808-560-3385
Is Sole Proprietor?:No
Enumeration Date:2021-08-17
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPSY-1922103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical