Individual
MRS. KATIE FEDERICK KAVANAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
508 BROADWAY ST, DELHI, LA 71232-3002
(318) 878-6376
(318) 878-6450
Mailing address
114 BROOKWOOD DR, VICKSBURG, MS 39183-8101
(601) 529-4211
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
8926
LA
Other
Enumeration date
06/16/2011
Last updated
06/16/2011
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