Provider Demographics
NPI:1841272242
Name:MILLET, EDWARD SCOTT
Entity type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:SCOTT
Last Name:MILLET
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5033 A IROQOUIS AVE
Mailing Address - Street 2:
Mailing Address - City:EWA BEACH
Mailing Address - State:HI
Mailing Address - Zip Code:96706
Mailing Address - Country:US
Mailing Address - Phone:808-499-1732
Mailing Address - Fax:
Practice Address - Street 1:BUILDING 556 HEARD ROAD
Practice Address - Street 2:SCHOFIELD BARRACKS
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96857
Practice Address - Country:US
Practice Address - Phone:808-655-9944
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY00045101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health