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Individual

SHAUNNA DEZRAE KAMANU'ENA HERMOSURA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
860 4TH ST STE 150, PEARL CITY, HI 96782-3690
(808) 453-6960
Mailing address
94-164 KUPUOHI PL, WAIPAHU, HI 96797-1122
(808) 306-5029

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT1120
HI
261QX0100X
Occupational Medicine Clinic/Center

Other

Enumeration date
07/03/2012
Last updated
10/07/2022
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