Healthcare Provider Details

I. General information

NPI: 1215281100
Provider Name (Legal Business Name): ROBYN M. UEHARA-TOM M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/31/2012
Last Update Date: 10/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

94-408 AKOKI STREET
WAIPAHU HI
96797-1813
US

IV. Provider business mailing address

94-408 AKOKI STREET
WAIPAHU HI
96797-1813
US

V. Phone/Fax

Practice location:
  • Phone: 808-676-5584
  • Fax:
Mailing address:
  • Phone: 808-676-5584
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP-383
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: