Provider Demographics
NPI:1659349843
Name:LOCHNER, LAURA (PHD)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:LOCHNER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 N AIR DEPOT BLVD
Mailing Address - Street 2:
Mailing Address - City:MIDWEST CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73110
Mailing Address - Country:US
Mailing Address - Phone:405-733-9516
Mailing Address - Fax:405-733-8853
Practice Address - Street 1:801 N AIR DEPOT BLVD
Practice Address - Street 2:
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73110
Practice Address - Country:US
Practice Address - Phone:405-733-9516
Practice Address - Fax:405-733-8853
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK895103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200017980AMedicaid
OK200017980AMedicaid