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General NPI Number Information
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NPI Number | 1720207657
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Entity Type | Individual
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Provider Name | DOREEN GRAY REDFORD LMT
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Gender | Female
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Dates
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Enumeration Date | 04/25/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1441 KAPIOLANI BLVD 813
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City | HONOLULU
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State | HI
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Zip | 96814-4402
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Country | US
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Telephone | 808-955-7246
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Fax | 808-955-7249
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Provider Business Mailing Address
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Address Line | 98-288 KAONOHI ST #3004
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City | AIEA
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State | HI
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Zip | 96701-2366
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Country | US
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Telephone | 808-366-5007
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Fax | 808-487-7854
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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 | 9992
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License Number State | HI
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