Healthcare Provider Details

I. General information

NPI: 1144020173
Provider Name (Legal Business Name): KAYLA ANN KALIKOKALEHUA EMIKO FOURNIER LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/18/2025
Last Update Date: 03/18/2025
Certification Date: 03/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 MONTCLAIRE DR SE APT 1
ALBUQUERQUE NM
87108
US

IV. Provider business mailing address

4311 ENFIELD CT SW
ALBUQUERQUE NM
87121-5490
US

V. Phone/Fax

Practice location:
  • Phone: 505-226-2652
  • Fax:
Mailing address:
  • Phone: 808-217-2623
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number2024-0122
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: