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General NPI Number Information
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NPI Number | 1548841968
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Entity Type | Individual
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Provider Name | KATELYN LEA ZIMMERMAN
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Gender | Female
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Dates
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Enumeration Date | 04/16/2021
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Last Update Date | 11/01/2024
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Provider Practice Location Address
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Address Line | 1401 S BERETANIA ST STE 900
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City | HONOLULU
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State | HI
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Zip | 96814-1875
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Country | US
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Telephone | 808-593-2830
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Fax |
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Provider Business Mailing Address
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Address Line | 269 N KALAHEO AVE # A
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City | KAILUA
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State | HI
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Zip | 96734-2319
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Country | US
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Telephone | 808-386-4097
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 1928
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License Number State | HI
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