Basic Information
| Provider Information | |||||||||
| NPI: | 1174954374 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | STIRLING | ||||||||
| FirstName: | LAURA | ||||||||
| MiddleName: | ANN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3947 HARDING AVE | ||||||||
| Address2: | |||||||||
| City: | HONOLULU | ||||||||
| State: | HI | ||||||||
| PostalCode: | 968164132 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8082221254 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4510 SALT LAKE BLVD STE D8 | ||||||||
| Address2: | |||||||||
| City: | HONOLULU | ||||||||
| State: | HI | ||||||||
| PostalCode: | 968183172 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8084861804 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/12/2013 | ||||||||
| LastUpdateDate: | 01/25/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 01/20/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103K00000X | 1-22-57512 | HI | Y | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.