Provider Demographics
NPI:1083097208
Name:KAWATA, MAYU (MT-BC, HHP)
Entity Type:Individual
Prefix:
First Name:MAYU
Middle Name:
Last Name:KAWATA
Suffix:
Gender:F
Credentials:MT-BC, HHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2752 WOODLAWN DR
Mailing Address - Street 2:5-209
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96822-1802
Mailing Address - Country:US
Mailing Address - Phone:808-988-0010
Mailing Address - Fax:
Practice Address - Street 1:2752 WOODLAWN DR
Practice Address - Street 2:5-209
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96822-1802
Practice Address - Country:US
Practice Address - Phone:808-988-0010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-07
Last Update Date:2015-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA08069225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist