Provider Demographics
NPI:1033560628
Name:HONAKER, LAINA CELESTE (COTA/L)
Entity Type:Individual
Prefix:
First Name:LAINA
Middle Name:CELESTE
Last Name:HONAKER
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5311 COUNTY ROAD 40
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:IN
Mailing Address - Zip Code:46721-9504
Mailing Address - Country:US
Mailing Address - Phone:260-645-0962
Mailing Address - Fax:
Practice Address - Street 1:11050 PRESBYTERIAN DR
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46236-2982
Practice Address - Country:US
Practice Address - Phone:812-235-6281
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-25
Last Update Date:2019-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN32002764A224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant