Provider Demographics
NPI:1720112576
Name:LORENZ, SYNTHA
Entity type:Individual
Prefix:
First Name:SYNTHA
Middle Name:
Last Name:LORENZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 KAMEHAMEHA AVE # 201
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-2860
Mailing Address - Country:US
Mailing Address - Phone:808-825-4214
Mailing Address - Fax:866-985-6799
Practice Address - Street 1:224 KAMEHAMEHA AVE # 201
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-2860
Practice Address - Country:US
Practice Address - Phone:808-825-4214
Practice Address - Fax:866-985-6799
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA39255106H00000X
HIMFT-709-0106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist