Healthcare Provider Details

I. General information

NPI: 1144267584
Provider Name (Legal Business Name): MAILE TANAKA SINGSON M.S.,CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

745 FORT ST
HONOLULU HI
96813-3816
US

IV. Provider business mailing address

252 KAHAKO ST
KAILUA HI
96734-5904
US

V. Phone/Fax

Practice location:
  • Phone: 808-497-3277
  • Fax: 808-261-6539
Mailing address:
  • Phone: 808-497-3277
  • Fax: 808-261-6539

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number080
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: