Provider Demographics
NPI:1265451512
Name:YOUNG, MICHELE MARGARET (OTR)
Entity Type:Individual
Prefix:MS
First Name:MICHELE
Middle Name:MARGARET
Last Name:YOUNG
Suffix:
Gender:F
Credentials:OTR
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 754
Mailing Address - Street 2:
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744-0754
Mailing Address - Country:US
Mailing Address - Phone:808-261-9792
Mailing Address - Fax:808-356-1078
Practice Address - Street 1:38 KANEOHE BAY DR
Practice Address - Street 2:
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-1747
Practice Address - Country:US
Practice Address - Phone:808-261-9792
Practice Address - Fax:808-356-1078
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2017-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIOT234225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand