Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XM0800X | Mental Health | OT 185 | HI |
NPI | 1356688519 |
---|---|
Provider Name | Susanne L Talbot |
First Address | Honolulu, HI 96813-2402 |
Second Address | Honolulu, HI 96813-2402 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/01/2013 |
Last Update Date | 08/01/2013 |