Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 153 | HI |
Y | 103T00000X | Psychologist | 153 | HI |
N | 103TH0100X | Health Service | 896 | MD |
NPI | 1255454583 |
---|---|
Provider Name | Linda C Fox |
First Address | Honolulu, HI 96817-0034 |
Second Address | Ewa Beach, HI 96706-1909 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2007 |
Last Update Date | 24/05/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
06167 | (05) | HI |