Provider Demographics
NPI:1104178300
Name:PAHIA, ROSLYN KULIA (LMT)
Entity Type:Individual
Prefix:
First Name:ROSLYN
Middle Name:KULIA
Last Name:PAHIA
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 KUPALAIKI LOOP
Mailing Address - Street 2:
Mailing Address - City:KIHEI
Mailing Address - State:HI
Mailing Address - Zip Code:96753-8119
Mailing Address - Country:US
Mailing Address - Phone:808-874-8908
Mailing Address - Fax:
Practice Address - Street 1:50 KUPALAIKI LOOP
Practice Address - Street 2:
Practice Address - City:KIHEI
Practice Address - State:HI
Practice Address - Zip Code:96753-8119
Practice Address - Country:US
Practice Address - Phone:808-269-1111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-11
Last Update Date:2012-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI10448225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist