Organization
METAMORPHOSIS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ILANA ALANEO FERNANDEZ PSY.D. (OWNER)
(808) 783-4404
Entity
Organization
Contact information
Practice address
50 CALASA RD, KULA, HI 96790-8101
(808) 783-4404
Mailing address
PO BOX 784, KULA, HI 96790-0784
(808) 783-4404
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
PSY - 959
HI
Other
Enumeration date
05/17/2012
Last updated
03/07/2014
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