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Individual

MRS. KONANE M DERYKE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR

Contact information

Practice address
6243 KAWAIHAE PL, HONOLULU, HI 96825-1911
(808) 258-3559
Mailing address
6243 KAWAIHAE PL, HONOLULU, HI 96825-1911
(808) 258-3559

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT-16
HI
225XL0004X
Low Vision Occupational Therapist
OT-16
HI
225XN1300X
Neurorehabilitation Occupational Therapist
OT-16
HI

Other

Enumeration date
07/29/2013
Last updated
07/29/2013
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