Provider Demographics
NPI:1093168007
Name:MEKOLA, LAURA (CHT)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:
Last Name:MEKOLA
Suffix:
Gender:F
Credentials:CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:171 S ANITA DR STE 200-D
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-3319
Mailing Address - Country:US
Mailing Address - Phone:714-272-2596
Mailing Address - Fax:
Practice Address - Street 1:171 S ANITA DR STE 200-D
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-3319
Practice Address - Country:US
Practice Address - Phone:714-272-2596
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-14
Last Update Date:2016-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor