Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 1040 | HI |
Y | 103TC0700X | Clinical Psychologist | 1040 | HI |
NPI | 1003080771 |
---|---|
Provider Name | Dr. Claren Kuulei Kealoha-Beaudet |
First Address | Kamuela, HI 96743-0818 |
Second Address | Kamuela, HI 96743-8440 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2008 |
Last Update Date | 13/01/2022 |