| |
77-137 Kalaniuka St. Holualoa HI 96725-9729 | |
(808) 322-2600 | |
(808) 322-2071 |
Full Name | |
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Speciality | Psychologist |
Location | 77-137 Kalaniuka St., Holualoa, Hawaii |
Authorized Official Name and Position | Kenneth Ray Kirchner (OWNER PRESIDENT) |
Authorized Official Contact | 8083222600 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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77-137 Kalaniuka St. Holualoa HI 96725-9729 Ph: (808) 322-2600 | 77-137 Kalaniuka St. Holualoa HI 96725-9729 Ph: (808) 322-2600 |
NPI Number | 1942495049 |
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Provider Enumeration Date | 09/11/2007 |
Last Update Date | 08/05/2010 |
Identifier | Type | State | Issuer |
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1942495049 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103T00000X | Psychologist | 710 (Hawaii) | Primary |
103T00000X | Psychologist | 474 (Colorado) | Secondary |