# MRS. CAROL ANN IADELUCA-MYRIANTHIS

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1477565745
- **Gender:** F
- **Credential:** PT, PSYD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 474 | HI | Yes |

## Other

- **Enumeration date:** 08/13/2006
- **Last updated:** 05/23/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 01853401 | — | HI |
| 05 | — | 01853402 | — | HI |
| 01 | — | A19867 | HMSA KA'U | HI |
| 01 | — | D19861 | HMSA PAHOA | HI |