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General NPI Number Information
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NPI Number | 1376908335
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Entity Type | Individual
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Provider Name | SATHIPORN SONGSORN LMT, PMT, PDSO
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Gender | Female
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Dates
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Enumeration Date | 12/17/2015
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Last Update Date | 11/12/2024
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Provider Practice Location Address
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Address Line | 92-1220 ALIINUI DR
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City | KAPOLEI
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State | HI
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Zip | 96707-4296
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Country | US
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Telephone | 808-979-6553
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Fax | 808-492-1133
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Provider Business Mailing Address
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Address Line | 92-1498 ALIINUI DR APT 4
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City | KAPOLEI
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State | HI
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Zip | 96707-4298
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Country | US
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Telephone | 808-979-6553
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Fax | 808-492-1133
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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-8376
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License Number State | HI
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