Provider Demographics
NPI:1801556923
Name:AYAKAWA, SIDNEY MALIA
Entity type:Individual
Prefix:
First Name:SIDNEY
Middle Name:MALIA
Last Name:AYAKAWA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91-1004 POLOLIA ST
Mailing Address - Street 2:
Mailing Address - City:EWA BEACH
Mailing Address - State:HI
Mailing Address - Zip Code:96706-3579
Mailing Address - Country:US
Mailing Address - Phone:808-250-5602
Mailing Address - Fax:
Practice Address - Street 1:91-1004 POLOLIA ST
Practice Address - Street 2:
Practice Address - City:EWA BEACH
Practice Address - State:HI
Practice Address - Zip Code:96706-3579
Practice Address - Country:US
Practice Address - Phone:808-250-5602
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-30
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist