Provider Demographics
NPI:1699175125
Name:MAEMORI, KATHY AKIYO (MS)
Entity type:Individual
Prefix:MRS
First Name:KATHY
Middle Name:AKIYO
Last Name:MAEMORI
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MS
Other - First Name:KATHY
Other - Middle Name:AKIYO
Other - Last Name:SADANAGA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:418 OPIHKAO PL
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96825
Mailing Address - Country:US
Mailing Address - Phone:808-277-9002
Mailing Address - Fax:
Practice Address - Street 1:418 OPIHKAO PL
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96825
Practice Address - Country:US
Practice Address - Phone:808-277-9002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-03
Last Update Date:2014-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HISP-211235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist