| Doctor Name: | DR. GINA ANN LEONG SAMALA |
| NPI Number: | 1386869691 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PSY.D. |
| License Number: | PSY-756 |
| Business Practice Address: | 95-1249 Meheula Pkwy Suite B30 Unit 195 Mililani, HI - 967891779 |
| Business Phone Number: | 8086257448 |
| Business Fax Number: | 8086257448 |
| Mailing Address: | 85-979 Farrington Hwy Ste C, WAIANAE |
| State: | HI |
| Postal Code: | 967922678 |
| Phone Number: | 8086257448 |
| Fax Number: | 8086257448 |
| NPI Enumeration Date: | 04/13/2007 |
| NPI Last Update Date: | 03/04/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | PSY-756 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | HI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |