Provider Demographics
NPI:1366163826
Name:KAUAI INTEGRATIVE THERAPIES
Entity type:Organization
Organization Name:KAUAI INTEGRATIVE THERAPIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:C
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:808-346-5856
Mailing Address - Street 1:PO BOX 1719
Mailing Address - Street 2:
Mailing Address - City:KAPAA
Mailing Address - State:HI
Mailing Address - Zip Code:96746-5719
Mailing Address - Country:US
Mailing Address - Phone:808-346-5856
Mailing Address - Fax:808-822-5454
Practice Address - Street 1:4-885 KUHIO HWY # A-1
Practice Address - Street 2:
Practice Address - City:KAPAA
Practice Address - State:HI
Practice Address - Zip Code:96746-2702
Practice Address - Country:US
Practice Address - Phone:808-346-5859
Practice Address - Fax:808-822-5454
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-02
Last Update Date:2022-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty