Doctor Name: | JACQUELINE NICOLE DEEGAN |
NPI Number: | 1720223928 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMT |
License Number: | MAT 10071, MAE 2420 |
Business Practice Address: | 15-2891 Pahoa Village Rd. Pahoa, HI - 967788214 |
Business Phone Number: | 8089656623 |
Business Fax Number: | |
Mailing Address: | 13-1233 Kahukai St, PAHOA |
State: | HI |
Postal Code: | 967788214 |
Phone Number: | 8089659603 |
Fax Number: | |
NPI Enumeration Date: | 12/03/2008 |
NPI Last Update Date: | 12/03/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | MAT 10071, MAE 2420 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | HI |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |