Individual
SAMANTHA HENRIQUES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, ATC, CSCS
Contact information
Practice address
4695 MAILIHUNA RD, KAPAA, HI 96746-2051
(808) 821-4401
(808) 821-4420
Mailing address
5011 MALU RD, KAPAA, HI 96746-1758
(808) 821-4401
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT-57
HI
Other
Enumeration date
07/24/2014
Last updated
07/24/2014
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