Individual
DR. ANTONIO GINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D., CSAC
Contact information
Practice address
1154 FORT STREET MALL STE 206, HONOLULU, HI 96813-2712
(808) 528-1184
Mailing address
PO BOX 25972, HONOLULU, HI 96825-0972
(808) 528-1184
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY-475
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00137401
—
HI
Enumeration date
05/12/2006
Last updated
07/09/2007
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