Basic Information
| Provider Information | |||||||||
| NPI: | 1619437043 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HYDE | ||||||||
| FirstName: | SARAH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 94-013 KUAHELANI AVE APT 137 | ||||||||
| Address2: | |||||||||
| City: | MILILANI | ||||||||
| State: | HI | ||||||||
| PostalCode: | 967891678 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8087418980 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4510 SALT LAKE BLVD | ||||||||
| Address2: | |||||||||
| City: | HONOLULU | ||||||||
| State: | HI | ||||||||
| PostalCode: | 968183153 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8084861804 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/21/2019 | ||||||||
| LastUpdateDate: | 12/14/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/14/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106S00000X | N | 103K00000X | 465 | HI | Y | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.