Basic Information
Provider Information
NPI: 1942748660
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCHWARTZ
FirstName: BETHANY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: CCC-SLP
OtherOrganizationName:  
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OtherLastName:  
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OtherCredential:  
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Mailing Information
Address1: 677 ALA MOANA BLVD
Address2: SUITE 1001
City: HONOLULU
State: HI
PostalCode: 968135419
CountryCode: US
TelephoneNumber: 8084694900
FaxNumber: 8085879507
Practice Location
Address1: 677 ALA MOANA BLVD
Address2: SUITE 625
City: HONOLULU
State: HI
PostalCode: 968135419
CountryCode: US
TelephoneNumber: 8086921580
FaxNumber: 8085666292
Other Information
ProviderEnumerationDate: 02/01/2017
LastUpdateDate: 02/01/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
235Z00000XSP-1069HIY Speech, Language and Hearing Service ProvidersSpeech-Language Pathologist 

No ID Information.


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