Individual
MS. ELSIE KIMIKO TARUMOTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
860 FOURTH ST, ROOM 150, PEARL CITY, HI 96782-3312
(808) 453-6969
(808) 453-6964
Mailing address
860 FOURTH ST, ROOM 150, PEARL CITY, HI 96782-3312
(808) 453-6960
(808) 453-6964
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP-149
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
044164
HPMMIS MEDICAID PROVIDER ID
HI
Enumeration date
03/20/2012
Last updated
03/20/2012
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