Organization
PSYCHOLOGICAL SERVICE CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL J LANE PH.D (CHIEF PSYCHOLOGIST)
(808) 280-9457
Entity
Organization
Contact information
Practice address
1135 MAKAWAO AVE, MAKAWAO, HI 96768-7403
(808) 280-9457
(808) 572-0311
Mailing address
126 PENI PL, KULA, HI 96790-8772
(808) 280-9457
(808) 572-0311
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A0258473
HMSA
HI
01
—
548195324
UNIVERSITY HEALTH ALLIANCE
HI
01
—
57950000-1
ALOHA CARE QUEST
HI
05
—
57950002
—
HI
Enumeration date
02/11/2009
Last updated
02/11/2009
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