Provider Demographics
NPI:1134541915
Name:TRAMMELL, LAURA (MED, LPC)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:TRAMMELL
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9212 N KELLEY AVE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73131-2419
Mailing Address - Country:US
Mailing Address - Phone:405-242-5070
Mailing Address - Fax:405-242-5071
Practice Address - Street 1:9212 N KELLEY AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73131-2419
Practice Address - Country:US
Practice Address - Phone:405-242-5070
Practice Address - Fax:405-242-5071
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-13
Last Update Date:2014-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1948101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor