Basic Information
| Provider Information | |||||||||
| NPI: | 1295223378 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LOMELAND | ||||||||
| FirstName: | LOUISE | ||||||||
| MiddleName: | |||||||||
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| Credential: | MA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2828 NE 49TH AVE LOT 131 | ||||||||
| Address2: | |||||||||
| City: | OCALA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 344703227 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3527892463 | ||||||||
| FaxNumber: | 3527325593 | ||||||||
| Practice Location | |||||||||
| Address1: | 2828 NE 49TH AVE LOT 131 | ||||||||
| Address2: | |||||||||
| City: | OCALA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 344703227 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3527892463 | ||||||||
| FaxNumber: | 3527325593 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/25/2018 | ||||||||
| LastUpdateDate: | 04/25/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | Y | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
No ID Information.