Healthcare Provider Details

I. General information

NPI: 1780226118
Provider Name (Legal Business Name): JOY KUO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2019
Last Update Date: 01/10/2024
Certification Date: 01/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3630 WOODLAWN TERRACE PL
HONOLULU HI
96822-1475
US

IV. Provider business mailing address

3630 WOODLAWN TERRACE PL
HONOLULU HI
96822-1475
US

V. Phone/Fax

Practice location:
  • Phone: 808-782-1027
  • Fax:
Mailing address:
  • Phone: 808-782-1027
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number2059
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: