Provider Demographics
NPI:1407164072
Name:PREBBLE, SARAH BRYONY (LMT)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:BRYONY
Last Name:PREBBLE
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 1:2961 E MANOA RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96822-6810
Mailing Address - Country:US
Mailing Address - Phone:808-988-7778
Mailing Address - Fax:808-744-4170
Practice Address - Street 1:2961 E MANOA RD
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96822-6810
Practice Address - Country:US
Practice Address - Phone:808-988-7778
Practice Address - Fax:808-744-4170
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-16
Last Update Date:2010-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI2342225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist