Provider Demographics
NPI:1922019611
Name:RUBENSTEIN, R SUSAN (PHD)
Entity type:Individual
Prefix:
First Name:R SUSAN
Middle Name:
Last Name:RUBENSTEIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 MAHALANI STREET
Mailing Address - Street 2:BEHAVIORAL HEALTH SERVICES
Mailing Address - City:WAILUKU
Mailing Address - State:HI
Mailing Address - Zip Code:96793-2526
Mailing Address - Country:US
Mailing Address - Phone:808-244-9056
Mailing Address - Fax:
Practice Address - Street 1:221 MAHALANI STREET
Practice Address - Street 2:
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793-2526
Practice Address - Country:US
Practice Address - Phone:808-442-5473
Practice Address - Fax:808-242-2488
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2009-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPSY585103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical