Provider Demographics
NPI:1366462566
Name:HO, LAUREN (DPT)
Entity Type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:
Last Name:HO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85-885 FARRINGTON HWY
Mailing Address - Street 2:
Mailing Address - City:WAIANAE
Mailing Address - State:HI
Mailing Address - Zip Code:96792-2440
Mailing Address - Country:US
Mailing Address - Phone:808-696-4764
Mailing Address - Fax:808-696-2853
Practice Address - Street 1:85-885 FARRINGTON HWY
Practice Address - Street 2:
Practice Address - City:WAIANAE
Practice Address - State:HI
Practice Address - Zip Code:96792-2440
Practice Address - Country:US
Practice Address - Phone:808-696-4764
Practice Address - Fax:808-696-2853
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2010-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPT1880225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI501066-01Medicaid
HI501066-01Medicaid