Individual
JENNIFER C BAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
472 KAULANA ST, KAHULUI, HI 96732-2050
(808) 877-2761
Mailing address
175 MOLOKAI AKAU ST, KAHULUI, HI 96732-2824
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
167
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000251900
HMSA
HI
Enumeration date
05/15/2007
Last updated
07/08/2007
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