Provider Demographics
NPI:1205126604
Name:ABEL, CAROLYN RACHELLE (LMT)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:RACHELLE
Last Name:ABEL
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1144
Mailing Address - Street 2:
Mailing Address - City:KURTISTOWN
Mailing Address - State:HI
Mailing Address - Zip Code:96760-1144
Mailing Address - Country:US
Mailing Address - Phone:808-990-4465
Mailing Address - Fax:
Practice Address - Street 1:16-576 KEAAU PAHOA RD
Practice Address - Street 2:
Practice Address - City:KEAAU
Practice Address - State:HI
Practice Address - Zip Code:96749-8105
Practice Address - Country:US
Practice Address - Phone:808-990-4465
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-19
Last Update Date:2011-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI10546225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist