Provider Demographics
NPI:1235507591
Name:HONEYCUTT, PATTI (LMT)
Entity Type:Individual
Prefix:
First Name:PATTI
Middle Name:
Last Name:HONEYCUTT
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42110 CHERRYLAWN CT
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-3715
Mailing Address - Country:US
Mailing Address - Phone:734-560-7417
Mailing Address - Fax:
Practice Address - Street 1:42110 CHERRYLAWN CT
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-3715
Practice Address - Country:US
Practice Address - Phone:734-560-7417
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-03
Last Update Date:2015-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7501001698225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist