Provider Demographics
NPI:1124215025
Name:MURRAY, MELINDA ELIZABETH HELEN
Entity Type:Individual
Prefix:
First Name:MELINDA
Middle Name:ELIZABETH HELEN
Last Name:MURRAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 453
Mailing Address - Street 2:
Mailing Address - City:KALAHEO
Mailing Address - State:HI
Mailing Address - Zip Code:96741-0453
Mailing Address - Country:US
Mailing Address - Phone:808-652-1954
Mailing Address - Fax:
Practice Address - Street 1:1196 NOHEA ST.
Practice Address - Street 2:
Practice Address - City:KALAHEO
Practice Address - State:HI
Practice Address - Zip Code:96741
Practice Address - Country:US
Practice Address - Phone:808-652-1954
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-25
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI293225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist