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Individual

ILIANA JESSICA GOODMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR/L, PAMS

Contact information

Practice address
472 KAULANA ST, KAHULUI, HI 96732-2050
(808) 877-7840
Mailing address
26 E WAIPUILANI RD, UNIT A, KIHEI, HI 96753-8219

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1507
HI

Other

Enumeration date
06/20/2016
Last updated
06/20/2016
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