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General NPI Number Information
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NPI Number | 1033632880
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Entity Type | Individual
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Provider Name | HAROLYN VICKS LMT
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Gender | Female
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Dates
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Enumeration Date | 07/24/2017
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Last Update Date | 06/07/2018
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Provider Practice Location Address
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Address Line | 350 WARD AVE STE 210
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City | HONOLULU
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State | HI
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Zip | 96814
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Country | US
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Telephone | 808-200-4611
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Fax |
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Provider Business Mailing Address
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Address Line | 728 COOLIDGE ST APT 17
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City | HONOLULU
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State | HI
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Zip | 96826-3064
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Country | US
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Telephone | 808-779-5288
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 15047
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License Number State | HI
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