Individual
MS. CAROLYN M GROSSNICKLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
710 GREEN ST, HONOLULU, HI 96813-2119
(808) 536-3764
Mailing address
3201 MOOHEAU AVE, HONOLULU, HI 96816-1219
(808) 732-0402
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT-476
HI
Other
Enumeration date
08/25/2009
Last updated
08/25/2009
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