Organization
MELISSA WILSON LMFT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA DIANE WILSON LMFT (OWNER/ PROVIDER)
(808) 651-4183
Entity
Organization
Contact information
Practice address
4374 KUKUI GROVE ST STE 102, LIHUE, HI 96766-2007
(808) 651-4183
Mailing address
3877D OMAO RD, KOLOA, HI 96756-9615
(808) 651-4183
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1285900084
—
HI
Enumeration date
10/07/2022
Last updated
11/02/2022
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