Provider Demographics
NPI:1316736200
Name:TONKIN, HAVILAH JOHANNA
Entity type:Individual
Prefix:
First Name:HAVILAH
Middle Name:JOHANNA
Last Name:TONKIN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 PARKVIEW DR
Mailing Address - Street 2:
Mailing Address - City:CELINA
Mailing Address - State:OH
Mailing Address - Zip Code:45822-1947
Mailing Address - Country:US
Mailing Address - Phone:614-381-9367
Mailing Address - Fax:
Practice Address - Street 1:101 PARKVIEW DR
Practice Address - Street 2:
Practice Address - City:CELINA
Practice Address - State:OH
Practice Address - Zip Code:45822-1947
Practice Address - Country:US
Practice Address - Phone:614-381-9367
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-06
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPS.005567175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist