Provider Demographics
NPI:1659434892
Name:HUMMEL, TED A (MS)
Entity Type:Individual
Prefix:
First Name:TED
Middle Name:A
Last Name:HUMMEL
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:283 S BUTLER RD
Mailing Address - Street 2:
Mailing Address - City:MT GRETNA
Mailing Address - State:PA
Mailing Address - Zip Code:17064-0550
Mailing Address - Country:US
Mailing Address - Phone:800-932-0359
Mailing Address - Fax:
Practice Address - Street 1:283 S BUTLER RD
Practice Address - Street 2:
Practice Address - City:MT GRETNA
Practice Address - State:PA
Practice Address - Zip Code:17064-0550
Practice Address - Country:US
Practice Address - Phone:800-932-0359
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS007256L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical