Provider Demographics
NPI:1336361146
Name:MCNALLY, ERIN COLLEEN (OTR)
Entity Type:Individual
Prefix:MISS
First Name:ERIN
Middle Name:COLLEEN
Last Name:MCNALLY
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 1299
Mailing Address - Street 2:
Mailing Address - City:KULA
Mailing Address - State:HI
Mailing Address - Zip Code:96790
Mailing Address - Country:US
Mailing Address - Phone:808-870-1618
Mailing Address - Fax:808-878-8100
Practice Address - Street 1:84 CENTRAL AVE.
Practice Address - Street 2:
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793
Practice Address - Country:US
Practice Address - Phone:808-870-1618
Practice Address - Fax:808-878-8100
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI211225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIA23785-7Medicare UPIN
HI55048Medicare PIN