Healthcare Provider Details

I. General information

NPI: 1811318850
Provider Name (Legal Business Name): ANN KATHERINE TEMPLE M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANNIE TEMPLE M.S.

II. Dates (important events)

Enumeration Date: 12/18/2013
Last Update Date: 08/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

475 22ND AVENUE BUILDING 302, ROOM 101
HONOLULU HI
96816
US

IV. Provider business mailing address

475 22ND AVENUE BUILDING 302, ROOM 101
HONOLULU HI
96816
US

V. Phone/Fax

Practice location:
  • Phone: 808-305-9750
  • Fax: 808-733-9154
Mailing address:
  • Phone: 808-305-9750
  • Fax: 808-733-9154

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number11635
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number1178
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: