Individual
DR. MICHELLE K. FUKUMOTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1110 UNIVERSITY AVE., SUITE #403, HONOLULU, HI 96826
(808) 594-6217
Mailing address
P.O. BOX 283249, HONOLULU, HI 96828
(808) 594-6217
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY-1502
HI
Other
Enumeration date
09/13/2010
Last updated
11/12/2014
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