Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OT-120 | HI |
N | 225XM0800X | Mental Health |
NPI | 1932553666 |
---|---|
Provider Name | Karen Rollins |
First Address | Wailuku, HI 96793-2168 |
Second Address | Wailuku, HI 96793-2526 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2016 |
Last Update Date | 19/04/2016 |