Provider Demographics
NPI:1265575872
Name:HONAKER, MICHELE ANNETTE
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:ANNETTE
Last Name:HONAKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 HYATT ST
Mailing Address - Street 2:
Mailing Address - City:RICHLANDS
Mailing Address - State:VA
Mailing Address - Zip Code:24641-2887
Mailing Address - Country:US
Mailing Address - Phone:276-701-5118
Mailing Address - Fax:276-880-1238
Practice Address - Street 1:306 HYATT ST
Practice Address - Street 2:
Practice Address - City:RICHLANDS
Practice Address - State:VA
Practice Address - Zip Code:24641-2887
Practice Address - Country:US
Practice Address - Phone:276-701-5118
Practice Address - Fax:276-880-1238
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator