Provider Demographics
NPI:1639387012
Name:GEORGE, BIANCA ANGELIKA
Entity Type:Individual
Prefix:MRS
First Name:BIANCA
Middle Name:ANGELIKA
Last Name:GEORGE
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 1:46-445 KAHUHIPA ST
Mailing Address - Street 2:APT A
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744-3578
Mailing Address - Country:US
Mailing Address - Phone:808-392-5511
Mailing Address - Fax:
Practice Address - Street 1:46-445 KAHUHIPA ST
Practice Address - Street 2:APT A
Practice Address - City:KANEOHE
Practice Address - State:HI
Practice Address - Zip Code:96744-3578
Practice Address - Country:US
Practice Address - Phone:808-392-5511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI9259225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist