| Lisa Duke Phd Llc | |
|
1001 Kamokila Blvd Ste 151 Kapolei HI 96707-2090 | |
| (808) 226-8204 | |
| (808) 676-9250 |
| Full Name | Lisa Duke Phd Llc |
|---|---|
| Speciality | Psychologist |
| Location | 1001 Kamokila Blvd Ste 151, Kapolei, Hawaii |
| Authorized Official Name and Position | Lisa Ann Duke (OWNER/PSYCHOLOGIST) |
| Authorized Official Contact | 8082268204 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lisa Duke Phd Llc 92-1017 Koio Dr Apt R Kapolei HI 96707-4291 Ph: (808) 226-8204 | Lisa Duke Phd Llc 1001 Kamokila Blvd Ste 151 Kapolei HI 96707-2090 Ph: (808) 226-8204 |
| NPI Number | 1184942849 |
|---|---|
| Provider Enumeration Date | 05/05/2010 |
| Last Update Date | 05/05/2010 |
| Medicare PECOS PAC ID | 7012043904 |
|---|---|
| Medicare Enrollment ID | O20100415000232 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184942849 | NPI | - | NPPES |
| 1417284514 | Other | HI | LISA DUKE INDIVIDUAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PSY 1154 (Hawaii) | Primary |
| Provider Name | Lisa A Duke |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1417284514 PECOS PAC ID: 2466588348 Enrollment ID: I20140115001678 |
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