Individual
MRS. STACEY FAYO TESHIMA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
161 S. WAKEA AVE., KAHULUI, HI 96752
(808) 244-7469
(808) 242-4762
Mailing address
161 S. WAKEA AVE, KAHULUI, HI 96752
(808) 244-7469
(808) 242-4762
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT 895
HI
Other
Enumeration date
06/04/2009
Last updated
07/28/2015
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