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Individual
KIM A WISE-GASTINELL
Active
Individual
KIM A WISE-GASTINELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PLPC, AD.D
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
PLC9874
LA
103TC1900X
Counseling Psychologist
PLC9874
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PLC9874
—
LA
Enumeration date
02/24/2016
Last updated
08/18/2026
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