Provider Demographics
NPI:1043534381
Name:KENNEDY, CHARLOTTE U (OT)
Entity Type:Individual
Prefix:
First Name:CHARLOTTE
Middle Name:U
Last Name:KENNEDY
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:CHARLOTTE
Other - Middle Name:C
Other - Last Name:UNEMORI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1325 S KIHEI RD
Mailing Address - Street 2:STE 102
Mailing Address - City:KIHEI
Mailing Address - State:HI
Mailing Address - Zip Code:96753-8145
Mailing Address - Country:US
Mailing Address - Phone:808-269-1720
Mailing Address - Fax:866-431-9522
Practice Address - Street 1:1325 S KIHEI RD STE 102
Practice Address - Street 2:
Practice Address - City:KIHEI
Practice Address - State:HI
Practice Address - Zip Code:96753-8145
Practice Address - Country:US
Practice Address - Phone:907-622-6363
Practice Address - Fax:907-622-6366
Is Sole Proprietor?:No
Enumeration Date:2010-03-15
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIOT-518225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist