Healthcare Provider Details

I. General information

NPI: 1558787705
Provider Name (Legal Business Name): MICHELLE REED OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2014
Last Update Date: 02/02/2024
Certification Date: 02/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 N VINEYARD BLVD STE A3255645
HONOLULU HI
96817-3950
US

IV. Provider business mailing address

200 N VINEYARD BLVD STE A3255645
HONOLULU HI
96817-3950
US

V. Phone/Fax

Practice location:
  • Phone: 808-501-0110
  • Fax: 808-204-2488
Mailing address:
  • Phone: 808-501-0110
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number1895
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code225XL0004X
TaxonomyLow Vision Occupational Therapist
License Number9052
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code225XL0004X
TaxonomyLow Vision Occupational Therapist
License Number1895
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: