Healthcare Provider Details

I. General information

NPI: 1225899669
Provider Name (Legal Business Name): TRANSFORMING TOMORROWS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2024
Last Update Date: 03/29/2025
Certification Date: 03/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 N HOLOPONO ST STE 108
KIHEI HI
96753-6946
US

IV. Provider business mailing address

2136 KONOU PL APT 105
KIHEI HI
96753-8776
US

V. Phone/Fax

Practice location:
  • Phone: 781-424-4120
  • Fax:
Mailing address:
  • Phone: 781-424-4120
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XM0800X
TaxonomyMental Health Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: MS. JENNIFER MARIE BUCKLEY
Title or Position: CEO
Credential: OTR/L
Phone: 781-424-4120