| Organization Name: | JACKIE GUADAGNOLI, PH.D. |
| NPI Number: | 1114190873 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JACKIE GUADAGNOLI (PSYCHOLOGIST) |
| Mailing Address: | 4-1558 Kuhio Hwy Kapaa |
| State: | HI US |
| Postal Code: | 967461856 |
| Phone Number: | 8083921111 |
| Fax Number: | 8082458762 |
| NPI Enumeration Date: | 04/02/2008 |
| NPI Last Update Date: | 04/02/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | PSY-817 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | HI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |