Individual
RUSSELL MUN YU LOO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
98-644 PUAILIMA ST, AIEA, HI 96701
(808) 487-1135
Mailing address
98-644 PUAILIMA ST, AIEA, HI 96701-2231
(808) 487-1135
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
146
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005312-01
—
HI
Enumeration date
11/22/2006
Last updated
07/08/2007
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