Healthcare Provider Details

I. General information

NPI: 1720943129
Provider Name (Legal Business Name): KELLY HEE THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1334 9TH AVE
HONOLULU HI
96816-2615
US

IV. Provider business mailing address

1334 9TH AVE
HONOLULU HI
96816-2615
US

V. Phone/Fax

Practice location:
  • Phone: 925-708-3692
  • Fax:
Mailing address:
  • Phone: 925-708-3692
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: KELLY HEE
Title or Position: PROVIDER
Credential: LCSW
Phone: 925-708-3692