Provider Demographics
NPI:1538603170
Name:HUMMEL, LAURA
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:HUMMEL
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 1:1131 BALTIMORE PIKE
Mailing Address - Street 2:STE B
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-5132
Mailing Address - Country:US
Mailing Address - Phone:410-838-6070
Mailing Address - Fax:410-838-6961
Practice Address - Street 1:2525 POT SPRING RD
Practice Address - Street 2:
Practice Address - City:LUTHERVILLE
Practice Address - State:MD
Practice Address - Zip Code:21093-2778
Practice Address - Country:US
Practice Address - Phone:410-308-9702
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-16
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD06869225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist