Provider Demographics
NPI:1801263744
Name:ALIMBOYOGUEN, LINDA MICHELLE (LMT)
Entity type:Individual
Prefix:MS
First Name:LINDA
Middle Name:MICHELLE
Last Name:ALIMBOYOGUEN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1114
Mailing Address - Street 2:
Mailing Address - City:LAWAI
Mailing Address - State:HI
Mailing Address - Zip Code:96765-1114
Mailing Address - Country:US
Mailing Address - Phone:808-651-9492
Mailing Address - Fax:
Practice Address - Street 1:3-2087 KAUMUALII HWY
Practice Address - Street 2:
Practice Address - City:LIHUE
Practice Address - State:HI
Practice Address - Zip Code:96766-9505
Practice Address - Country:US
Practice Address - Phone:808-651-9492
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-26
Last Update Date:2015-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMAT 7012225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist