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Organization

ELEMENTAL GUIDANCE LLC

Active
Other names
Elemental Couple and Family Therapy
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. VISHWANI RAM-SOUZA MA, LMFT (CO-OWNER)
(612) 644-0737
Entity
Organization

Contact information

Practice address
260 KAMEHAMEHA AVE, HILO, HI 96720-2859
(612) 644-0737
Mailing address
260 KAMEHAMEHA AVE, HILO, HI 96720-2859
(612) 644-0737

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MFT-438
HI
261QM0855X
Adolescent and Children Mental Health Clinic/Center
MFT-397
HI

Other

Enumeration date
04/22/2017
Last updated
04/22/2017
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