Provider Demographics
NPI:1134641426
Name:HONODEL, LISA JANN
Entity type:Individual
Prefix:MISS
First Name:LISA
Middle Name:JANN
Last Name:HONODEL
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 1:7021 LAGO RANCHERO DR
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73026-3521
Mailing Address - Country:US
Mailing Address - Phone:405-593-5732
Mailing Address - Fax:
Practice Address - Street 1:7021 LAGO RANCHERO DR
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73026-3521
Practice Address - Country:US
Practice Address - Phone:405-593-5732
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator