Provider Demographics
NPI:1225575863
Name:HONNAKORE, SWAPNAJA M
Entity Type:Individual
Prefix:MS
First Name:SWAPNAJA
Middle Name:M
Last Name:HONNAKORE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:706 N. DIAMOND BAR BLVD
Mailing Address - Street 2:B2
Mailing Address - City:DIAMOND BAR
Mailing Address - State:NA
Mailing Address - Zip Code:91765
Mailing Address - Country:UM
Mailing Address - Phone:909-396-8900
Mailing Address - Fax:909-396-9900
Practice Address - Street 1:706 N. DIAMOND BAR BLVD
Practice Address - Street 2:B2
Practice Address - City:DIAMOND BAR
Practice Address - State:CA
Practice Address - Zip Code:91765
Practice Address - Country:US
Practice Address - Phone:909-396-8900
Practice Address - Fax:909-396-9900
Is Sole Proprietor?:No
Enumeration Date:2017-01-20
Last Update Date:2017-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP23658235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist