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Individual

DIANNA M DIFRENNA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMT

Contact information

Practice address
1129 LOWER MAIN ST, #205, WAILUKU, HI 96793-2053
(808) 242-7111
(808) 242-1393
Mailing address
1129 LOWER MAIN ST, #205, WAILUKU, HI 96793-2053
(808) 242-7111
(808) 242-1393

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
2455
HI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2455
STATE LICENSE
HI
01
4299
NCBTMB
HI
01
9899
AMTA
HI
Enumeration date
12/04/2006
Last updated
07/08/2007
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