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General NPI Number Information
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NPI Number | 1528635026
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Entity Type | Organization
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Legal Business Name | OUTDOOR OHANA OCCUPATIONAL THERAPY, LLC
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Dates
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Enumeration Date | 06/04/2021
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Last Update Date | 06/04/2021
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Provider Practice Location Address
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Address Line | 619 PAOPUA LOOP
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City | KAILUA
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State | HI
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Zip | 96734-3535
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Country | US
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Telephone | 510-688-0671
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Fax |
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Provider Business Mailing Address
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Address Line | 619 PAOPUA LOOP
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City | KAILUA
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State | HI
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Zip | 96734-3535
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Country | US
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Telephone | 510-688-0671
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Fax |
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Authorized Official
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Title or Position | FOUNDER & OCCUPATIONAL THERAPIST
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Name | DR. GABRIELLE M WHITE
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Credential | OTD, OTR/L
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Telephone | 510-688-0671
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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