Organization
JACKIE GUADAGNOLI, PH.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACKIE GUADAGNOLI PH.D. (PSYCHOLOGIST)
(808) 392-1111
Entity
Organization
Contact information
Practice address
4-1558 KUHIO HWY, KAPAA, HI 96746-1856
(808) 392-1111
(808) 245-8762
Mailing address
4-1558 KUHIO HWY, KAPAA, HI 96746-1856
(808) 392-1111
(808) 245-8762
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY-817
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
55079017
—
HI
Enumeration date
04/02/2008
Last updated
04/02/2008
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