Provider Demographics
NPI:1164109054
Name:TRAPELLA, SKY ALEXANDRA (LMT)
Entity Type:Individual
Prefix:
First Name:SKY
Middle Name:ALEXANDRA
Last Name:TRAPELLA
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 1:3154 KAUNAOA ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96815-4258
Mailing Address - Country:US
Mailing Address - Phone:860-248-5729
Mailing Address - Fax:
Practice Address - Street 1:750 KAPAHULU AVE
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-6020
Practice Address - Country:US
Practice Address - Phone:860-248-5729
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-03
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMAT-17768225700000X
CT11061225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist