Basic Information
| Provider Information | |||||||||
| NPI: | 1861519936 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MAYS | ||||||||
| FirstName: | KATHLEEN | ||||||||
| MiddleName: | LOUISE | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | M.S., CCC-SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1728 PORTER AVE | ||||||||
| Address2: | |||||||||
| City: | HONOLULU | ||||||||
| State: | HI | ||||||||
| PostalCode: | 968184740 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6054318401 | ||||||||
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| Practice Location | |||||||||
| Address1: | 677 ALA MOANA BLVD | ||||||||
| Address2: | SUITE 625 | ||||||||
| City: | HONOLULU | ||||||||
| State: | HI | ||||||||
| PostalCode: | 968135419 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8086921580 | ||||||||
| FaxNumber: | 8085666292 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/23/2007 | ||||||||
| LastUpdateDate: | 01/17/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
ID Information
| ID | Type | State | Issuer | Description | 12018449 | 01 | ASHA - CCC | OTHER | 47320 | 01 | SD | SANFORD HEALTH PLAN | OTHER | SP - 1224 | 01 | HI | STATE OF HAWAII DEPARTMENT OF COMMERCE AND CONSUMER AFFAIRS | OTHER | 5834230 | 05 | SD | MEDICAID | 65153-00 | 01 | SD | SCHOOL SERVICE SPECIALIST | OTHER |