Provider Demographics
NPI:1689876385
Name:LESAGE-OYAMOT, TERRI S (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:TERRI
Middle Name:S
Last Name:LESAGE-OYAMOT
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91-6589 KAPOLEI PKWY
Mailing Address - Street 2:
Mailing Address - City:EWA BEACH
Mailing Address - State:HI
Mailing Address - Zip Code:96706-6070
Mailing Address - Country:US
Mailing Address - Phone:808-372-7952
Mailing Address - Fax:808-689-3623
Practice Address - Street 1:99-080 KAUHALE ST STE D9
Practice Address - Street 2:
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-4114
Practice Address - Country:US
Practice Address - Phone:808-483-4901
Practice Address - Fax:808-483-4914
Is Sole Proprietor?:No
Enumeration Date:2007-06-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI635235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist