Provider Demographics
NPI:1629382080
Name:THERAPEUTIC SPECIALISTS INC
Entity Type:Organization
Organization Name:THERAPEUTIC SPECIALISTS INC
Other - Org Name:THERAPEUTIC SPECIALISTS
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DARYL-JEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WONG
Authorized Official - Suffix:
Authorized Official - Credentials:COTA
Authorized Official - Phone:808-489-7444
Mailing Address - Street 1:1273 ALEWA DR
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-1511
Mailing Address - Country:US
Mailing Address - Phone:808-489-7444
Mailing Address - Fax:808-595-7444
Practice Address - Street 1:1273 ALEWA DR
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-1511
Practice Address - Country:US
Practice Address - Phone:808-489-7444
Practice Address - Fax:808-595-7444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-28
Last Update Date:2020-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIOT-269225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty