Organization
KONA THERAPY ASSOCIATES INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRUCE A. HANSEN PH.D. (DIRECTOR)
(808) 961-5500
Entity
Organization
Contact information
Practice address
101 AUPUNI ST., STE #118, HILO, HI 96720-4260
(808) 961-5500
Mailing address
101 AUPUNI ST., STE #118, HILO, HI 96720-4260
(808) 961-5500
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04937802
—
HI
05
—
04937803
—
HI
Enumeration date
11/27/2006
Last updated
08/22/2020
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