Doctor Name: | DR. VALERIE JO WILLMAN |
NPI Number: | 1083704001 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PH.D. |
License Number: | PSY887 |
Business Practice Address: | 2-4131 Kaumualii Hwy Lawai, HI - 96765 |
Business Phone Number: | 8086450742 |
Business Fax Number: | |
Mailing Address: | Po Box 25, ELEELE |
State: | HI |
Postal Code: | 967050025 |
Phone Number: | 8086450742 |
Fax Number: | |
NPI Enumeration Date: | 10/13/2006 |
NPI Last Update Date: | 09/30/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | PSY887 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | HI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |