Provider Demographics
NPI:1437859170
Name:HONSTETTER ENTERPRISES, INC
Entity type:Organization
Organization Name:HONSTETTER ENTERPRISES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TARA
Authorized Official - Middle Name:
Authorized Official - Last Name:HONSTETTER
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:208-240-4155
Mailing Address - Street 1:3050 N LAKEHARBOR LN STE 214
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83703-6243
Mailing Address - Country:US
Mailing Address - Phone:208-240-4155
Mailing Address - Fax:208-470-8733
Practice Address - Street 1:3050 N LAKEHARBOR LN STE 214
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83703-6243
Practice Address - Country:US
Practice Address - Phone:208-254-0441
Practice Address - Fax:208-470-8733
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-09
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty