Provider Demographics
NPI:1912103482
Name:GARELLO, JUDITH ANN (OTR)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:ANN
Last Name:GARELLO
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 KOEHANA PL
Mailing Address - Street 2:
Mailing Address - City:MAKAWAO
Mailing Address - State:HI
Mailing Address - Zip Code:96768-7900
Mailing Address - Country:US
Mailing Address - Phone:808-342-3614
Mailing Address - Fax:808-891-9219
Practice Address - Street 1:111 HANA HWY
Practice Address - Street 2:
Practice Address - City:KAHULUI
Practice Address - State:HI
Practice Address - Zip Code:96732-2300
Practice Address - Country:US
Practice Address - Phone:808-342-3614
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI664225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist