Provider Demographics
NPI:1417350927
Name:HAKEL'S GENESIS 1
Entity Type:Organization
Organization Name:HAKEL'S GENESIS 1
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:PATTY
Authorized Official - Middle Name:JILL
Authorized Official - Last Name:HAKEL
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:405-436-4371
Mailing Address - Street 1:6501 E ROBINSON ST
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73026-3543
Mailing Address - Country:US
Mailing Address - Phone:405-436-4371
Mailing Address - Fax:
Practice Address - Street 1:6501 E ROBINSON ST
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73026-3543
Practice Address - Country:US
Practice Address - Phone:405-436-4371
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-29
Last Update Date:2014-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4842101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty