Provider Demographics
NPI:1700379989
Name:HONSAKER, THERESA E (R EPT, CNIM)
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:E
Last Name:HONSAKER
Suffix:
Gender:F
Credentials:R EPT, CNIM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5106 SUMTER AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45238-3827
Mailing Address - Country:US
Mailing Address - Phone:513-378-7451
Mailing Address - Fax:
Practice Address - Street 1:8118 CORPORATE WAY STE 212
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-9560
Practice Address - Country:US
Practice Address - Phone:513-947-8433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-12
Last Update Date:2018-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic