Provider Demographics
NPI:1609023449
Name:BURT, PAUL JAMES (MS)
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:JAMES
Last Name:BURT
Suffix:
Gender:M
Credentials:MS
Other - Prefix:MR
Other - First Name:PAUL
Other - Middle Name:JAMES
Other - Last Name:BURT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS
Mailing Address - Street 1:PO BOX 1232
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:HI
Mailing Address - Zip Code:96771-1232
Mailing Address - Country:US
Mailing Address - Phone:808-935-7949
Mailing Address - Fax:808-935-5996
Practice Address - Street 1:234 WAIANUENUE AVE
Practice Address - Street 2:SUITE 215
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-2418
Practice Address - Country:US
Practice Address - Phone:808-935-7949
Practice Address - Fax:808-935-5996
Is Sole Proprietor?:No
Enumeration Date:2008-08-22
Last Update Date:2008-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health