Organization
THE LAVENDER CLINIC
Active
Other names
The Lavender Center & Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MS. STEPHANIE MIKHAIL (DIRECTOR OF OPERATIONS)
(808) 744-2543
Entity
Organization
Contact information
Practice address
1481 S KING ST STE 422, HONOLULU, HI 96814-2600
(808) 744-2543
(866) 451-4608
Mailing address
1481 S KING ST STE 422, HONOLULU, HI 96814-2600
(808) 744-2543
(866) 451-4608
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
104100000X
Social Worker
—
—
207Q00000X
Family Medicine Physician
—
—
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
835481
—
HI
Enumeration date
10/06/2014
Last updated
10/25/2021
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