Healthcare Provider Details

I. General information

NPI: 1689352205
Provider Name (Legal Business Name): MARIKO MAPLES OCCUPATIONAL THERAPY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2023
Last Update Date: 07/06/2023
Certification Date: 07/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

94-1181 KA UKA BLVD STE C
WAIPAHU HI
96797-4485
US

IV. Provider business mailing address

94-1181 KA UKA BLVD STE C
WAIPAHU HI
96797-4485
US

V. Phone/Fax

Practice location:
  • Phone: 808-260-9056
  • Fax: 808-444-3353
Mailing address:
  • Phone: 808-260-9056
  • Fax: 808-444-3353

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOT-2336
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: