Provider Demographics
NPI:1326238007
Name:STOKES, CAROLYN RENEE (LMT)
Entity Type:Individual
Prefix:MS
First Name:CAROLYN
Middle Name:RENEE
Last Name:STOKES
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:PO BOX 5493
Mailing Address - Street 2:
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744-9166
Mailing Address - Country:US
Mailing Address - Phone:808-728-0500
Mailing Address - Fax:
Practice Address - Street 1:47-337 MAHAKEA RD
Practice Address - Street 2:
Practice Address - City:KANEOHE
Practice Address - State:HI
Practice Address - Zip Code:96744-4942
Practice Address - Country:US
Practice Address - Phone:808-728-0500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-27
Last Update Date:2007-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMAT 6137225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist