Provider Demographics
NPI:1295223378
Name:LOMELAND, LOUISE (MA)
Entity Type:Individual
Prefix:
First Name:LOUISE
Middle Name:
Last Name:LOMELAND
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2828 NE 49TH AVE LOT 131
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34470-3227
Mailing Address - Country:US
Mailing Address - Phone:352-789-2463
Mailing Address - Fax:352-732-5593
Practice Address - Street 1:2828 NE 49TH AVE LOT 131
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34470-3227
Practice Address - Country:US
Practice Address - Phone:352-789-2463
Practice Address - Fax:352-732-5593
Is Sole Proprietor?:No
Enumeration Date:2018-04-25
Last Update Date:2018-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)