Provider Demographics
NPI:1760553085
Name:HOHENSTEIN, MALISSA A
Entity Type:Individual
Prefix:
First Name:MALISSA
Middle Name:A
Last Name:HOHENSTEIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MALISSA
Other - Middle Name:A
Other - Last Name:SPURLOCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 236
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47006-0236
Mailing Address - Country:US
Mailing Address - Phone:812-933-5441
Mailing Address - Fax:
Practice Address - Street 1:188 STATE ROAD 129 S
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:IN
Practice Address - Zip Code:47006-7628
Practice Address - Country:US
Practice Address - Phone:812-932-5902
Practice Address - Fax:812-933-5034
Is Sole Proprietor?:No
Enumeration Date:2006-11-10
Last Update Date:2021-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34006109A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical