Provider Demographics
NPI:1861524647
Name:BARRETTO, SUSAN HELENE (RPT)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:HELENE
Last Name:BARRETTO
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1608
Mailing Address - Street 2:
Mailing Address - City:KOLOA
Mailing Address - State:HI
Mailing Address - Zip Code:96756-1608
Mailing Address - Country:US
Mailing Address - Phone:808-634-7236
Mailing Address - Fax:
Practice Address - Street 1:3115 AKAHI ST
Practice Address - Street 2:
Practice Address - City:LIHUE
Practice Address - State:HI
Practice Address - Zip Code:96766-1106
Practice Address - Country:US
Practice Address - Phone:808-245-7141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI0293225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist