NPI 1730877812
Legendary Health Performance, LLC
Practice location
- Address
- 86-058 Alta St, Waianae, HI 96792-3031
- Phone
- (808) 358-0800
- Mailing address
- PO Box 4055, Waianae, HI 96792-7055
Authorised official
- Name
- Tiffany Jarae Wilson-Landrum
- Title
- Licensed Clinical Psychologist
- Phone
- (808) 358-0800
Registered specialties
Community/Behavioral Health Agency
Primary
Registry record
- NPI
- 1730877812
- Entity type
- Organization
- NPI issued
- 27 Apr 2023
- Record last updated
- 27 Apr 2023
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.