Provider Demographics
NPI:1871875815
Name:MUELLER, KRISTI LEILANI (PSYD)
Entity type:Individual
Prefix:DR
First Name:KRISTI
Middle Name:LEILANI
Last Name:MUELLER
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 256673
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96825-6502
Mailing Address - Country:US
Mailing Address - Phone:808-859-2017
Mailing Address - Fax:
Practice Address - Street 1:850 W HIND DR STE 110
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96821-1845
Practice Address - Country:US
Practice Address - Phone:808-859-2017
Practice Address - Fax:844-740-7062
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5176103T00000X
AL1706103TC0700X
HI1657103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAD000Medicare UPIN