Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 333 | HI |
Y | 103T00000X | Psychologist | 333 | HI |
NPI | 1013918291 |
---|---|
Provider Name | Dr. Naomi Takemoto-Chock |
First Address | Hilo, HI 96720-5941 |
Second Address | Hilo, HI 96720-5941 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2005 |
Last Update Date | 12/09/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02373701 | (05) | HI |