Provider Demographics
NPI:1386281848
Name:GIRON, YVONNE PEGGY (LMT)
Entity type:Individual
Prefix:
First Name:YVONNE
Middle Name:PEGGY
Last Name:GIRON
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 1:64-5193 KINOHOU STREET
Mailing Address - Street 2:SUITE 106
Mailing Address - City:KAMUELA
Mailing Address - State:HI
Mailing Address - Zip Code:96743
Mailing Address - Country:US
Mailing Address - Phone:480-388-7800
Mailing Address - Fax:
Practice Address - Street 1:64-5193 KINOHOU STREET
Practice Address - Street 2:SUITE 106
Practice Address - City:KAMUELA
Practice Address - State:HI
Practice Address - Zip Code:96743
Practice Address - Country:US
Practice Address - Phone:480-388-7800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-04
Last Update Date:2019-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMAT-15386225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist