Ayae T Tueller
Individual provider Active NPI Recreation Therapist · Koloa, HI
NPI 1124986393 · NPPES record last updated Jan 14, 2026
Key facts
- NPI
- 1124986393
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Recreation Therapist 225800000X
- License
- 58257 (HI)
- Practice address
- 3459 Lawailoa LN
Koloa, HI 96756-9646 - Phone
- (808) 276-3435
- NPI assigned
- Jan 14, 2026
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 58257 | HI | MD | Recreation Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Recreation Therapist | 225800000X | 58257 | HI | Yes |
Addresses
Primary practice location
3459 Lawailoa LN
Koloa, HI 96756-9646
Mailing address
3459 Lawailoa LN
Koloa, HI 96756-9646
Phone (808) 276-3435
Other providers in Koloa, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 14, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.