Healthcare Provider Details

I. General information

NPI: 1699687152
Provider Name (Legal Business Name): MISS CABELA HONEY GOLISH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4803 S 7TH ST
TERRE HAUTE IN
47802-4565
US

IV. Provider business mailing address

90 HOWARD DR
SHELBYVILLE KY
40065-8138
US

V. Phone/Fax

Practice location:
  • Phone: 812-269-5038
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number9370-87-5259
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: