Provider Demographics
NPI:1326315391
Name:HEWSTON, AMBER ELIZABETH (MSPT)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:ELIZABETH
Last Name:HEWSTON
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:ELIZABETH
Other - Last Name:COCHRAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:92-461 MAKAKILO DR
Mailing Address - Street 2:
Mailing Address - City:KAPOLEI
Mailing Address - State:HI
Mailing Address - Zip Code:96707-1270
Mailing Address - Country:US
Mailing Address - Phone:802-760-0222
Mailing Address - Fax:
Practice Address - Street 1:92-461 MAKAKILO DR
Practice Address - Street 2:
Practice Address - City:KAPOLEI
Practice Address - State:HI
Practice Address - Zip Code:96707-1270
Practice Address - Country:US
Practice Address - Phone:802-760-0222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-18
Last Update Date:2012-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPT-3363225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist