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NPI Code Detail

MEDICARE: LEAH ETSUKO TERAMOTO

MEDICARE: LEAH ETSUKO TERAMOTO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior TechnicianRBT-22-220087HI

General Provider Information

NPI Number : 1215669692
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEAH ETSUKO TERAMOTO
Provider Business Mailing Address
First Line : PO BOX 820
Second Line :
City : HOLUALOA
State : HI
Zip : 96725-0820
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 74-5078 KUMAKANI ST
Second Line :
City : KAILUA KONA
State : HI
Zip : 96740-1530
Country : US
Telephone Number : 808-746-1779
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/25/2022
Last Update Date : 06/25/2022

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Directions to “ LEAH ETSUKO TERAMOTO ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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