Healthcare Provider Details

I. General information

NPI: 1104754548
Provider Name (Legal Business Name): MARY JO HONIOTES M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6457 S JACKSON ST
CENTENNIAL CO
80121-3630
US

IV. Provider business mailing address

6457 S JACKSON ST
CENTENNIAL CO
80121-3630
US

V. Phone/Fax

Practice location:
  • Phone: 720-592-8092
  • Fax: 720-528-7722
Mailing address:
  • Phone: 720-592-8092
  • Fax: 720-528-7722

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: