Provider Demographics
NPI:1760765796
Name:HALE, KATLYN (PSYD)
Entity type:Individual
Prefix:DR
First Name:KATLYN
Middle Name:
Last Name:HALE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1061
Mailing Address - Street 2:
Mailing Address - City:KEALAKEKUA
Mailing Address - State:HI
Mailing Address - Zip Code:96750-1061
Mailing Address - Country:US
Mailing Address - Phone:808-430-0336
Mailing Address - Fax:
Practice Address - Street 1:79-938 W HONALO RD
Practice Address - Street 2:
Practice Address - City:KAILUA-KONA
Practice Address - State:HI
Practice Address - Zip Code:96740
Practice Address - Country:US
Practice Address - Phone:808-430-0336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-26
Last Update Date:2025-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPSY-1594103T00000X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist