Provider Demographics
NPI:1356631956
Name:FUJIKI, MIKI HONDA (MA/CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MIKI
Middle Name:HONDA
Last Name:FUJIKI
Suffix:
Gender:F
Credentials:MA/CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 MARVILO AVE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19805-2037
Mailing Address - Country:US
Mailing Address - Phone:302-543-5883
Mailing Address - Fax:
Practice Address - Street 1:3 MARVILO AVE
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19805-2037
Practice Address - Country:US
Practice Address - Phone:302-543-5883
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-15
Last Update Date:2011-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE01-0000961235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1553313OtherDELAWARE DRIVER'S LICENSE