Provider Demographics
NPI:1871519280
Name:CLIVIO, CYNTHIA LOUISE (ATC)
Entity type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:LOUISE
Last Name:CLIVIO
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:779 KII ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96825-1004
Mailing Address - Country:US
Mailing Address - Phone:808-396-3146
Mailing Address - Fax:
Practice Address - Street 1:1887 MAKUAKANE ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-1800
Practice Address - Country:US
Practice Address - Phone:808-842-8503
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer