Provider Demographics
NPI:1841603651
Name:MAUL DE SOTO, CORINNE (ND)
Entity Type:Individual
Prefix:
First Name:CORINNE
Middle Name:
Last Name:MAUL DE SOTO
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75-5995 KUAKINI HWY STE 445
Mailing Address - Street 2:
Mailing Address - City:KAILUA KONA
Mailing Address - State:HI
Mailing Address - Zip Code:96740-2123
Mailing Address - Country:US
Mailing Address - Phone:808-638-3343
Mailing Address - Fax:844-308-3545
Practice Address - Street 1:75-5995 KUAKINI HWY STE 445
Practice Address - Street 2:
Practice Address - City:KAILUA KONA
Practice Address - State:HI
Practice Address - Zip Code:96740-2123
Practice Address - Country:US
Practice Address - Phone:808-638-3343
Practice Address - Fax:844-308-3545
Is Sole Proprietor?:No
Enumeration Date:2014-06-09
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI258175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath