Individual
ANDREA ILIMA DECOSTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1020 GREEN ST, 106, HONOLULU, HI 96822-3619
(808) 737-5554
Mailing address
1020 GREEN ST, 106, HONOLULU, HI 96822-3619
(808) 737-5554
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
7113
HI
Other
Enumeration date
01/05/2015
Last updated
01/05/2015
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