Doctor Name: | DR. REUBEN LELAH |
NPI Number: | 1164834321 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PSY.D. |
License Number: | PSY560 |
Business Practice Address: | 73-4340 Huehue St Kailua Kona, HI - 967408695 |
Business Phone Number: | 8083251111 |
Business Fax Number: | 8083251110 |
Mailing Address: | 73-4340 Huehue St, KAILUA KONA |
State: | HI |
Postal Code: | 967408695 |
Phone Number: | 8083251111 |
Fax Number: | 8083251110 |
NPI Enumeration Date: | 05/22/2014 |
NPI Last Update Date: | 05/22/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | PSY560 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | HI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |