Healthcare Provider Details

I. General information

NPI: 1831044494
Provider Name (Legal Business Name): KAMMY HODGES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/28/2026
Last Update Date: 02/28/2026
Certification Date: 02/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 11513
LAHAINA HI
96761-6513
US

IV. Provider business mailing address

46 HUI RD F
LAHAINA HI
96761-9135
US

V. Phone/Fax

Practice location:
  • Phone: 808-781-4465
  • Fax:
Mailing address:
  • Phone: 808-781-4465
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMAT-17443
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: