Individual
DR. WALTER R. JAECKLE I
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
65-1235 OPELO RD, SUITE 1, KAMUELA, HI 96743-8454
(808) 885-1045
(808) 885-1045
Mailing address
65-1235 OPELO RD, SUITE 1, KAMUELA, HI 96743-8454
(808) 885-1045
(808) 885-1045
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY 116
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00402265
—
HI
Enumeration date
05/17/2006
Last updated
07/09/2007
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