Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | 1044 | HI |
N | 103T00000X | Psychologist | 1044 | HI |
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 1044 | HI |
N | 103TA0700X | Adult Development & Aging Psychologist | 1044 | HI |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 1044 | HI |
Y | 103G00000X | Clinical Psychologist | 1044 | HI |
Y | 103TC0700X | Clinical Psychologist | 1044 | HI |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 1044 | HI |
N | 103TF0000X | Family Psychologist | 1044 | HI |
N | 103TF0200X | Forensic Psychologist | 1044 | HI |
N | 103TH0004X | Health Psychologist | 1044 | HI |
N | 103TH0100X | Health Service | 1044 | HI |
N | 103TP2701X | Group Psychotherapist | 1044 | HI |
NPI | 1588811814 |
---|---|
Provider Name | Dr. Carol Jane Goldblatt |
First Address | Honolulu, HI 96813-3020 |
Second Address | Honolulu, HI 96813-3020 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2008 |
Last Update Date | 19/08/2008 |