Healthcare Provider Details

I. General information

NPI: 1316586357
Provider Name (Legal Business Name): CATHERINE M RUNGEE OTD, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/21/2019
Last Update Date: 12/21/2019
Certification Date: 12/21/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1210 WILHELMINA RISE STE B
HONOLULU HI
96816-3287
US

IV. Provider business mailing address

1706 18TH AVE S STE 201
NASHVILLE TN
37212-3189
US

V. Phone/Fax

Practice location:
  • Phone: 808-260-9056
  • Fax: 877-518-7858
Mailing address:
  • Phone: 615-848-4947
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number1824
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: