# MILESTONES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1881108652
- **Authorized official:** IRISA DEVINE MD (MEDICAL DIRECTOR)
- **Authorized official phone:** (808) 979-6700

## Contact information

- **Practice address:** 820 MILILANI ST STE 400, HONOLULU, HI 96813-2934
- **Practice address phone:** (808) 979-6700
- **Practice address fax:** (808) 441-9875
- **Mailing address:** 820 MILILANI ST STE 400, HONOLULU, HI 96813-2934
- **Mailing address phone:** (808) 979-6700
- **Mailing address fax:** (808) 441-9875

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103K00000X | Behavior Analyst | — | NULL | — |
| 103K00000X | Behavior Analyst | — | — | — |
| 103TC2200X | Clinical Child & Adolescent Psychologist | — | NULL | — |
| 103TC2200X | Clinical Child & Adolescent Psychologist | — | — | — |
| 2080P0008X | Pediatric Neurodevelopmental Disabilities Physician | — | NULL | — |
| 2080P0008X | Pediatric Neurodevelopmental Disabilities Physician | — | — | — |
| 225XP0200X | Pediatric Occupational Therapist | — | NULL | — |
| 225XP0200X | Pediatric Occupational Therapist | — | — | — |
| 235Z00000X | Speech-Language Pathologist | — | NULL | — |
| 235Z00000X | Speech-Language Pathologist | — | — | — |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 11/30/2017
- **Last updated:** 03/17/2018