Individual
STEPHANIE GODDARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.T.
Contact information
Practice address
1437 KILAUEA AVE STE 103, HILO, HI 96720-4200
(808) 854-0675
Mailing address
1437 KILAUEA AVE STE 103, HILO, HI 96720-4200
(808) 854-0675
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
11302
HI
Other
Enumeration date
06/08/2015
Last updated
06/08/2015
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