Provider Demographics
NPI:1548156540
Name:LOMMEL, LIBBY MARIE
Entity type:Individual
Prefix:
First Name:LIBBY
Middle Name:MARIE
Last Name:LOMMEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1541 MONKS AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56001-5137
Mailing Address - Country:US
Mailing Address - Phone:320-492-0478
Mailing Address - Fax:
Practice Address - Street 1:1541 MONKS AVE APT 3
Practice Address - Street 2:
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-5137
Practice Address - Country:US
Practice Address - Phone:320-492-0478
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-16
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician