Provider Demographics
NPI:1124708144
Name:AKAMIA WELLNESS SERVIES
Entity type:Organization
Organization Name:AKAMIA WELLNESS SERVIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:DONOVAN
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:808-938-4162
Mailing Address - Street 1:73-4322 KEOKEO ST
Mailing Address - Street 2:
Mailing Address - City:KAILUA KONA
Mailing Address - State:HI
Mailing Address - Zip Code:96740-8540
Mailing Address - Country:US
Mailing Address - Phone:808-938-4162
Mailing Address - Fax:
Practice Address - Street 1:73-4322 KEOKEO ST
Practice Address - Street 2:
Practice Address - City:KAILUA KONA
Practice Address - State:HI
Practice Address - Zip Code:96740-8540
Practice Address - Country:US
Practice Address - Phone:808-938-4162
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-24
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health