| Doctor Name: | MR. RONALD EVAN HORMEL |
| NPI Number: | 1003173113 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.A., L.L.P.C., N.C. |
| License Number: | 6401012805 |
| Business Practice Address: | 2075 West Big Beaver Road Suite 520 Troy, MI - 48084 |
| Business Phone Number: | 2486466659 |
| Business Fax Number: | 2486428645 |
| Mailing Address: | 2075 West Big Beaver Road, Suite 520 TROY |
| State: | MI |
| Postal Code: | 48084 |
| Phone Number: | 2486466659 |
| Fax Number: | 2486428645 |
| NPI Enumeration Date: | 04/13/2012 |
| NPI Last Update Date: | 07/24/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 6401012805 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |