Provider Demographics
NPI:1356424824
Name:AZAMA, SHERI L (OTR)
Entity type:Individual
Prefix:
First Name:SHERI
Middle Name:L
Last Name:AZAMA
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:SHERI
Other - Middle Name:L
Other - Last Name:LIEBERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR, OTD, CHT
Mailing Address - Street 1:1401 S BERETANIA ST STE 730
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-1881
Mailing Address - Country:US
Mailing Address - Phone:808-593-2830
Mailing Address - Fax:808-593-2840
Practice Address - Street 1:1401 S BERETANIA ST STE 730
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-1881
Practice Address - Country:US
Practice Address - Phone:808-593-2830
Practice Address - Fax:808-593-2840
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2014-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIOT440225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI549074Medicaid
HI56446Medicare PIN