Provider Demographics
NPI:1265888481
Name:NOMURA, JUDITH E (MA CCC-SLP, ATP)
Entity type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:E
Last Name:NOMURA
Suffix:
Gender:F
Credentials:MA CCC-SLP, ATP
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Mailing Address - Street 1:2499 KAPIOLANI BLVD
Mailing Address - Street 2:APT. 2308
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96826-5310
Mailing Address - Country:US
Mailing Address - Phone:808-225-5959
Mailing Address - Fax:
Practice Address - Street 1:94-428 MOKUOLA ST
Practice Address - Street 2:#305A
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-6300
Practice Address - Country:US
Practice Address - Phone:808-382-5008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-06
Last Update Date:2016-05-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
HI504235Z00000X
CA9297235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist