Healthcare Provider Details

I. General information

NPI: 1871690164
Provider Name (Legal Business Name): ALYSA LEIGH ANCHETA-GARBER OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

347 PATTERSON ROAD (CFA)
HONOLULU HI
96719-1522
US

IV. Provider business mailing address

347 PATTERSON ROAD (CFA)
HONOLULU HI
96719-1522
US

V. Phone/Fax

Practice location:
  • Phone: 808-433-0246
  • Fax: 808-433-0281
Mailing address:
  • Phone: 808-433-0246
  • Fax: 808-433-0281

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number1014182
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: