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General NPI Number Information
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NPI Number | 1487192001
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Entity Type | Organization
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Legal Business Name | ISLAND ABILITIES LLC
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Dates
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Enumeration Date | 02/02/2017
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Last Update Date | 02/02/2017
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Provider Practice Location Address
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Address Line | 95-1023 HAALILO ST
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City | MILILANI
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State | HI
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Zip | 96789-6575
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Country | US
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Telephone | 808-352-5052
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Fax |
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Provider Business Mailing Address
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Address Line | 95-1023 HAALILO ST
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City | MILILANI
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State | HI
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Zip | 96789-6575
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Country | US
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Telephone | 808-352-5052
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Fax |
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Authorized Official
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Title or Position | OWNER MEMBER
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Name | LISA DORAN
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Credential | M.S. CCC-SLP
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Telephone | 808-352-5052
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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-762
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License Number State | HI
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