Organization
MILESTONES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IRISA DEVINE MD (MEDICAL DIRECTOR)
(808) 979-6700
Entity
Organization
Contact information
Practice address
820 MILILANI ST STE 400, HONOLULU, HI 96813-2934
(808) 979-6700
(808) 441-9875
Mailing address
820 MILILANI ST STE 400, HONOLULU, HI 96813-2934
(808) 979-6700
(808) 441-9875
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
2080P0008X
Pediatric Neurodevelopmental Disabilities Physician
—
—
225XP0200X
Pediatric Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
11/30/2017
Last updated
03/17/2018
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