Provider Demographics
NPI:1023698156
Name:KAOHU, MIKAYLAH
Entity type:Individual
Prefix:MS
First Name:MIKAYLAH
Middle Name:
Last Name:KAOHU
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 1:47-417 AHUIMANU RD APT A
Mailing Address - Street 2:
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744-4852
Mailing Address - Country:US
Mailing Address - Phone:808-726-9898
Mailing Address - Fax:
Practice Address - Street 1:47-417 AHUIMANU RD APT A
Practice Address - Street 2:
Practice Address - City:KANEOHE
Practice Address - State:HI
Practice Address - Zip Code:96744-4852
Practice Address - Country:US
Practice Address - Phone:808-726-9898
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-13
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
HIAT4072255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program