Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PSY-1020 | HI |
Y | 103TC0700X | Clinical Psychologist | PSY-1020 | HI |
N | 103TH0100X | Health Service |
NPI | 1538239785 |
---|---|
Provider Name | Dr. Halona Wes Tanner |
First Address | Kaneohe, HI 96744-3805 |
Second Address | Kaneohe, HI 96744-4128 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2006 |
Last Update Date | 25/01/2021 |