Provider Demographics
NPI:1003677071
Name:ALOHA SPEECH PATHOLOGY SERVICES LLC
Entity Type:Organization
Organization Name:ALOHA SPEECH PATHOLOGY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:TRACHTENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MS-CCC-SLP
Authorized Official - Phone:845-699-1449
Mailing Address - Street 1:91-1443 KAIKOHOLA ST
Mailing Address - Street 2:
Mailing Address - City:EWA BEACH
Mailing Address - State:HI
Mailing Address - Zip Code:96706-6521
Mailing Address - Country:US
Mailing Address - Phone:845-699-1449
Mailing Address - Fax:808-892-1021
Practice Address - Street 1:91-1443 KAIKOHOLA ST
Practice Address - Street 2:
Practice Address - City:EWA BEACH
Practice Address - State:HI
Practice Address - Zip Code:96706-6521
Practice Address - Country:US
Practice Address - Phone:845-699-1449
Practice Address - Fax:808-892-1021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-17
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty