Provider Demographics
NPI:1750417291
Name:BRANDON, CATHERINE LOUISE (DAC)
Entity type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:LOUISE
Last Name:BRANDON
Suffix:
Gender:F
Credentials:DAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 AEWA PL
Mailing Address - Street 2:
Mailing Address - City:MAKAWAO
Mailing Address - State:HI
Mailing Address - Zip Code:96768-8882
Mailing Address - Country:US
Mailing Address - Phone:808-572-5599
Mailing Address - Fax:
Practice Address - Street 1:7 AEWA PL
Practice Address - Street 2:
Practice Address - City:MAKAWAO
Practice Address - State:HI
Practice Address - Zip Code:96768-8882
Practice Address - Country:US
Practice Address - Phone:808-572-5599
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI448171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist