Provider Demographics
NPI:1376193466
Name:MILLON, MARIA MARCELINA
Entity Type:Individual
Prefix:MISS
First Name:MARIA
Middle Name:MARCELINA
Last Name:MILLON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4182 HALUPA ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96818-1815
Mailing Address - Country:US
Mailing Address - Phone:808-426-8166
Mailing Address - Fax:
Practice Address - Street 1:4182 HALUPA ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96818-1815
Practice Address - Country:US
Practice Address - Phone:808-426-8166
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-19
Last Update Date:2019-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI15740225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist