Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TB0200X | Cognitive & Behavioral Psychologist | PSY-1555 | HI |
Y | 103G00000X | Clinical Psychologist | PSY-1555 | HI |
Y | 103TC0700X | Clinical Psychologist | PSY-1555 | HI |
N | 103TH0004X | Health Psychologist | PSY-1555 | HI |
N | 103TP2701X | Group Psychotherapist | PSY-1555 | HI |
NPI | 1013392364 |
---|---|
Provider Name | Dr. Lauren Elaine Ampolos |
First Address | Kahului, HI 96732-2348 |
Second Address | Kahului, HI 96732-2348 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2015 |
Last Update Date | 28/07/2015 |