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Organization
ISLAND THERAPEUTIC SPECIALISTS LLC
Active
Organization
ISLAND THERAPEUTIC SPECIALISTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERESA CRUZAN MS CCC-SLP (CEO/DIRECTOR OF THERAPEUTIC SERVICE)
(808) 238-9565
Entity
Organization
Contact information
Practice address
81-6587 MAMALAHOA HWY, SUITE C-203, KEALAKEKUA, HI 96750
(808) 987-2451
Mailing address
PO BOX 928, CAPTAIN COOK, HI 96704-0928
(808) 987-2451
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1535-10
HI
101YA0400X
Addiction (Substance Use Disorder) Counselor
1663-12
HI
1041C0700X
Clinical Social Worker
3904
HI
235Z00000X
Speech-Language Pathologist
Primary
1055
HI
235Z00000X
Speech-Language Pathologist
1286
HI
Other
Enumeration date
10/01/2013
Last updated
05/05/2014
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