Organization
TRACY M TANIGUCHI PSY D LLC
Active
Other names
Tracy M.T. Watanabe, Psy.D.,LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TRACY M.T. YAMASAKI PSY.D. (CLINICAL PSYCHOLOGIST)
(808) 227-7682
Entity
Organization
Contact information
Practice address
688 KINOOLE ST, SUITE # 206, HILO, HI 96720-3877
(808) 227-7682
(877) 795-7918
Mailing address
688 KINOOLE ST, SUITE # 206, HILO, HI 96720-3877
(808) 227-7682
(877) 795-7918
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1320
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1013275205
NPI TYPE 1
HI
Enumeration date
11/04/2015
Last updated
12/01/2022
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