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General NPI Number Information
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NPI Number | 1245434984
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Entity Type | Individual
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Provider Name | TERESITA AGPAOA SOTELO LMT
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Gender | Female
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Dates
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Enumeration Date | 06/14/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1750 KALAKAUA AVE SUITE 3601
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City | HONOLULU
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State | HI
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Zip | 96826-3766
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Country | US
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Telephone | 808-955-7735
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Fax |
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Provider Business Mailing Address
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Address Line | 1550 MAKAMUA ST
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City | PEARL CITY
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State | HI
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Zip | 96782-2021
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Country | US
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Telephone | 808-206-4450
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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 | MAT 9770
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License Number State | HI
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