Healthcare Provider Details

I. General information

NPI: 1932553666
Provider Name (Legal Business Name): KAREN ROLLINS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2016
Last Update Date: 04/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

221 MAHALANI ST
WAILUKU HI
96793-2526
US

IV. Provider business mailing address

14 OHIA LAKA PL
WAILUKU HI
96793-2168
US

V. Phone/Fax

Practice location:
  • Phone: 808-242-2660
  • Fax:
Mailing address:
  • Phone: 808-214-7155
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT-120
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code225XM0800X
TaxonomyMental Health Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: