Provider Demographics
NPI:1669239927
Name:HO, DIANA (DAC, LAC, LMT)
Entity type:Individual
Prefix:DR
First Name:DIANA
Middle Name:
Last Name:HO
Suffix:
Gender:F
Credentials:DAC, LAC, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3458A EDNA ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96815-4395
Mailing Address - Country:US
Mailing Address - Phone:808-600-4333
Mailing Address - Fax:
Practice Address - Street 1:3608 DIAMOND HEAD CIR
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96815-4430
Practice Address - Country:US
Practice Address - Phone:415-439-0470
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-04
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMAT-17760225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist