NPI 1003117268

Susan J Licoan, PSYD

Practitioner Clinical Psychologist Ookala, HI

Practice location

Address: 39 3301 Milo Place, Ookala, HI 96774
Phone: (808) 896-7186
Fax: (808) 962-6943
Mailing address: PO Box 1578, Honokaa, HI 96727-1578

Registered specialties

Clinical Psychologist Primary

Behavioral Health & Social Service Providers Taxonomy 103TC0700X Licence 1214 (HI)

Other Psychologist providers in Hawaii →

Registry record

NPI: 1003117268
Entity type: Individual
Sex (as registered): Female
NPI issued: 4 Nov 2010
Record last updated: 12 May 2013

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.