Provider Demographics
NPI:1659686376
Name:RODLI, NORA (LMT)
Entity Type:Individual
Prefix:MS
First Name:NORA
Middle Name:
Last Name:RODLI
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:MS
Other - First Name:NORA
Other - Middle Name:
Other - Last Name:RODLI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT, RN
Mailing Address - Street 1:41-037 HIHIMANU ST APT C
Mailing Address - Street 2:
Mailing Address - City:WAIMANALO
Mailing Address - State:HI
Mailing Address - Zip Code:96795-1638
Mailing Address - Country:US
Mailing Address - Phone:918-804-8460
Mailing Address - Fax:
Practice Address - Street 1:932 WARD AVE
Practice Address - Street 2:6TH FLOOR
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-2131
Practice Address - Country:US
Practice Address - Phone:808-535-5555
Practice Address - Fax:808-535-5556
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-18
Last Update Date:2014-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI13614225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI13614OtherLICENSED MASSAGE THERAPIST