Healthcare Provider Details

I. General information

NPI: 1356673727
Provider Name (Legal Business Name): SPEECH PATHOLOGY OF HAWAII LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2010
Last Update Date: 06/17/2024
Certification Date: 06/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 KAPIOLANI BLVD STE C206
HONOLULU HI
96813-6024
US

IV. Provider business mailing address

725 KAPIOLANI BLVD STE C206
HONOLULU HI
96813-6024
US

V. Phone/Fax

Practice location:
  • Phone: 808-596-0099
  • Fax:
Mailing address:
  • Phone: 808-596-0099
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number1035
License Number StateHI
# 3
Primary TaxonomyN
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number12311
License Number StateCA

VIII. Authorized Official

Name: CAROLINDA T MURPHY
Title or Position: SPEECH/LANGUAGE PATHOLOGIST
Credential: MS CCC-SLP; OM
Phone: 808-224-8569