Individual
SHANE LYKA CORPUZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
45-090 NAMOKU ST, KANEOHE, HI 96744-5305
(808) 497-2353
Mailing address
94-1167 KAHUAINA ST, WAIPAHU, HI 96797-3406
(808) 497-2353
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA-332
HI
Other
Enumeration date
12/13/2024
Last updated
12/13/2024
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