Provider Demographics
NPI:1508042839
Name:BORKHUIS, SUSANNE MALIA (MOT, OTR/L, CLT)
Entity Type:Individual
Prefix:MRS
First Name:SUSANNE
Middle Name:MALIA
Last Name:BORKHUIS
Suffix:
Gender:F
Credentials:MOT, OTR/L, CLT
Other - Prefix:MS
Other - First Name:SUSANNE
Other - Middle Name:MALIA
Other - Last Name:STANLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:7000 HAWAII KAI DR APT 3606
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96825-4200
Mailing Address - Country:US
Mailing Address - Phone:210-601-1398
Mailing Address - Fax:
Practice Address - Street 1:1401 S BERETANIA ST STE 730
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-1881
Practice Address - Country:US
Practice Address - Phone:808-593-2830
Practice Address - Fax:808-593-2840
Is Sole Proprietor?:No
Enumeration Date:2008-01-16
Last Update Date:2017-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1629225XH1200X
TX110964225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand