Provider Demographics
NPI:1578142527
Name:SHERRY, SAVANNAH-RAE (DPT)
Entity Type:Individual
Prefix:
First Name:SAVANNAH-RAE
Middle Name:
Last Name:SHERRY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:SAVANNAH-RAE
Other - Middle Name:
Other - Last Name:MOLINA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:5722 KALANIANAOLE HWY
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96821-2388
Mailing Address - Country:US
Mailing Address - Phone:808-358-1587
Mailing Address - Fax:808-373-3666
Practice Address - Street 1:5722 KALANIANAOLE HWY
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96821-2388
Practice Address - Country:US
Practice Address - Phone:808-358-1587
Practice Address - Fax:808-373-3666
Is Sole Proprietor?:No
Enumeration Date:2021-04-06
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1342493225100000X
HIPT5674225100000X
CT13724225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist