Wise-Gastinell, Kim A

Wise-Gastinell, Kim A is an individual health care provider with primary practice located at 5635 Tarrytown Ave , Baton Rouge LA 70808-3535. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Counseling. Behavioral Health & Social Service Providers / Counseling is her primary health care specialty. Wise-Gastinell, Kim A can be contacted via phone (225) 476-3809.

Contact Information

Primary practice address
5635 Tarrytown Ave Baton Rouge LA 70808-3535
Phone: (225) 476-3809
Fax: (225) 256-2668
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X
Behavioral Health & Social Service Providers / Counseling 103TC1900X PLC9874 Louisiana

Profile Details

NPI number 1255791802
LBN Legal business name Wise-Gastinell, Kim A
Credentials AD.D
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 24th, 2016
Last updated Nov 6th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255791802 NPPES
Louisiana MEDICAID PLC9874

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