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Organization
PARENT CHILD THERAPY CENTER
Active
Organization
PARENT CHILD THERAPY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHANTEL FERNANDEZ LOPEZ PHD (PSYCHOLOGIST)
(808) 681-2309
Entity
Organization
Contact information
Practice address
590 FARRINGTON HWY # 524-114, KAPOLEI, HI 96707-2009
(808) 681-2309
Mailing address
590 FARRINGTON HWY # 524-114, KAPOLEI, HI 96707-2009
(808) 681-2309
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
NULL
103T00000X
Psychologist
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
NULL
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TC0700X
Clinical Psychologist
—
NULL
103TC0700X
Clinical Psychologist
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
—
NULL
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
—
—
103TF0000X
Family Psychologist
—
NULL
103TF0000X
Family Psychologist
—
—
103TP2701X
Group Psychotherapy Psychologist
—
NULL
103TP2701X
Group Psychotherapy Psychologist
—
—
Other
Enumeration date
07/16/2021
Last updated
07/16/2021
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