Individual
JILLIAN FREITAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
95 MAHALANI ST RM 21, WAILUKU, HI 96793-2521
(808) 244-4647
Mailing address
95 MAHALANI ST RM 21, WAILUKU, HI 96793-2521
(808) 244-4647
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY-1747
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500673381
—
OR
Enumeration date
09/15/2014
Last updated
11/16/2018
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