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General NPI Number Information
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NPI Number | 1750911012
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Entity Type | Individual
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Provider Name | CHRISTINA MARIE RICCHI LMT
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Gender | Female
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Dates
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Enumeration Date | 01/24/2020
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Last Update Date | 01/24/2020
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Provider Practice Location Address
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Address Line | 3660 BALDWIN AVE STE C
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City | MAKAWAO
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State | HI
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Zip | 96768-7503
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Country | US
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Telephone | 808-214-2340
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Fax |
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Provider Business Mailing Address
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Address Line | 1493 W KUIAHA RD
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City | HAIKU
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State | HI
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Zip | 96708-5525
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Country | US
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Telephone | 415-717-4621
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 16259
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License Number State | HI
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