Provider Demographics
NPI:1891250049
Name:HONEA, THALIA L (OTR/L)
Entity Type:Individual
Prefix:
First Name:THALIA
Middle Name:L
Last Name:HONEA
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 MCDOWELL ST
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-4434
Mailing Address - Country:US
Mailing Address - Phone:904-346-3465
Mailing Address - Fax:
Practice Address - Street 1:12766 SAN JOSE BLVD
Practice Address - Street 2:SUITE 716 & 717
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32223
Practice Address - Country:US
Practice Address - Phone:904-288-9604
Practice Address - Fax:904-288-9643
Is Sole Proprietor?:No
Enumeration Date:2019-02-01
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT19771225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist