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General NPI Number Information
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NPI Number | 1154451532
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Entity Type | Individual
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Provider Name | MICHELLE PEREIRA CAMACHO M.S. CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 94-144 FARRINGTON HWY STE 115
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City | WAIPAHU
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State | HI
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Zip | 96797-1918
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Country | US
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Telephone | 808-678-3637
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Fax | 808-678-3820
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Provider Business Mailing Address
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Address Line | 94-402 KAPUAHI ST APT 51
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City | MILILANI
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State | HI
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Zip | 96789-2529
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Country | US
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Telephone | 808-371-2892
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SP-761
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License Number State | HI
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