| Melissa Wilson Lmft Llc | |
|
4374 Kukui Grove St Ste 102 Lihue HI 96766-2007 | |
| (808) 651-4183 | |
| Not Available |
| Full Name | Melissa Wilson Lmft Llc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 4374 Kukui Grove St Ste 102, Lihue, Hawaii |
| Authorized Official Name and Position | Melissa Diane Wilson (OWNER/ PROVIDER) |
| Authorized Official Contact | 8086514183 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Melissa Wilson Lmft Llc 3877d Omao Rd Koloa HI 96756-9615 Ph: (808) 651-4183 | Melissa Wilson Lmft Llc 4374 Kukui Grove St Ste 102 Lihue HI 96766-2007 Ph: (808) 651-4183 |
| NPI Number | 1831814284 |
|---|---|
| Provider Enumeration Date | 10/07/2022 |
| Last Update Date | 11/02/2022 |
| Certification Date | 11/02/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831814284 | NPI | - | NPPES |
| 1285900084 | Medicaid | HI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
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