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Individual

DR. HAWKEN SHIELDS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PSYD

Contact information

Practice address
76-5914 MAMALAHOA HWY, HOLUALOA, HI 96725
(808) 640-0645
Mailing address
PO BOX 1546, KEALAKEKUA, HI 96750-1546
(808) 640-0645

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY-838
HI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
57177001
HI
Enumeration date
12/19/2006
Last updated
08/24/2011
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