Individual
SOUSADA PHITSAMAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
575 FARRINGTON HWY, KAPOLEI, HI 96707-2001
(808) 674-9262
Mailing address
91-1039 HANAPAA ST, KAPOLEI, HI 96707-1937
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
694
HI
Other
Enumeration date
05/16/2007
Last updated
07/08/2007
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