Organization
MARK D BREITHAUOT PHD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK DOUGLAS BREITHAUPT PHD (PARTNER)
(808) 205-8403
Entity
Organization
Contact information
Practice address
2200 MAIN ST STE 510, WAILUKU, HI 96793-1624
(808) 205-8403
Mailing address
PO BOX 2632, WAILUKU, HI 96793-7632
(808) 205-8403
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Enumeration date
10/02/2025
Last updated
10/02/2025
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