Provider Demographics
NPI:1528305117
Name:HOMMEL, LOUIS GEORGE (MA)
Entity type:Individual
Prefix:MR
First Name:LOUIS
Middle Name:GEORGE
Last Name:HOMMEL
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3520 S GOULD ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73129-6728
Mailing Address - Country:US
Mailing Address - Phone:405-642-3295
Mailing Address - Fax:
Practice Address - Street 1:3520 S GOULD ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73129-6728
Practice Address - Country:US
Practice Address - Phone:405-642-3295
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-15
Last Update Date:2013-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health