Organization
PACIFIC ENTERPRISE GROUP, LLC
Active
Other names
Hawaii Memory Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES THOMAS HARDING PSY.D., M.A. (DIRECTOR)
(808) 927-9038
Entity
Organization
Contact information
Practice address
98-501 KOAUKA LOOP, A-702, AIEA, HI 96701-4550
(808) 927-9038
Mailing address
PO BOX 276, AIEA, HI 96701-0276
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PSY1077
HI
103TA0700X
Adult Development & Aging Psychologist
PSY1077
HI
Other
Enumeration date
08/05/2010
Last updated
08/05/2010
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