Provider Demographics
NPI:1285737593
Name:TADA, DAYLE MARI (OTR)
Entity type:Individual
Prefix:MRS
First Name:DAYLE
Middle Name:MARI
Last Name:TADA
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:MISS
Other - First Name:DAYLE
Other - Middle Name:MARI
Other - Last Name:NAKAMURA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:3465 WAIALAE AVENUE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816
Mailing Address - Country:US
Mailing Address - Phone:808-753-7617
Mailing Address - Fax:808-735-3556
Practice Address - Street 1:3465 WAIALAE AVENUE
Practice Address - Street 2:SUITE 102
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816
Practice Address - Country:US
Practice Address - Phone:808-753-7617
Practice Address - Fax:808-735-3556
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIOT154225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist