Provider Demographics
NPI:1528702255
Name:HONICKA, DOMINIKA (MS)
Entity type:Individual
Prefix:MRS
First Name:DOMINIKA
Middle Name:
Last Name:HONICKA
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:227 BRADLEY CT
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:PA
Mailing Address - Zip Code:18966-2758
Mailing Address - Country:US
Mailing Address - Phone:126-793-4422
Mailing Address - Fax:
Practice Address - Street 1:227 BRADLEY CT
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:PA
Practice Address - Zip Code:18966-2758
Practice Address - Country:US
Practice Address - Phone:267-934-4225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-27
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health