Healthcare Provider Details

I. General information

NPI: 1639300783
Provider Name (Legal Business Name): SUZANN MICHELLE WOJCIECHOWSKI OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2009
Last Update Date: 11/30/2020
Certification Date: 11/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1325 S KIHEI RD STE 102
KIHEI HI
96753-8145
US

IV. Provider business mailing address

1325 S KIHEI RD STE 102
KIHEI HI
96753-8145
US

V. Phone/Fax

Practice location:
  • Phone: 808-269-1720
  • Fax: 866-431-9522
Mailing address:
  • Phone: 808-385-4048
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XE0001X
TaxonomyEnvironmental Modification Occupational Therapist
License Number210
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code225XF0002X
TaxonomyFeeding, Eating & Swallowing Occupational Therapist
License Number210
License Number StateHI
# 3
Primary TaxonomyN
Taxonomy Code225XG0600X
TaxonomyGerontology Occupational Therapist
License Number210
License Number StateHI
# 4
Primary TaxonomyN
Taxonomy Code225XN1300X
TaxonomyNeurorehabilitation Occupational Therapist
License Number210
License Number StateHI
# 5
Primary TaxonomyN
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number210
License Number StateHI
# 6
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number210
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: