Provider Demographics
NPI:1255483566
Name:YEE, CAROL AT (OTR, CHT)
Entity Type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:AT
Last Name:YEE
Suffix:
Gender:F
Credentials:OTR, CHT
Other - Prefix:MS
Other - First Name:CAROL
Other - Middle Name:A
Other - Last Name:TICHEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OTR, CHT
Mailing Address - Street 1:1401 S BERETANIA ST STE 730
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-1881
Mailing Address - Country:US
Mailing Address - Phone:808-593-2830
Mailing Address - Fax:808-593-2840
Practice Address - Street 1:1401 S BERETANIA ST STE 730
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-1881
Practice Address - Country:US
Practice Address - Phone:808-593-2830
Practice Address - Fax:808-593-2840
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2013-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIOT-13225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIOT013OtherSTATE LICENSE
HI490194Medicaid
HI490194Medicaid
HIOT013OtherSTATE LICENSE