Individual
DR. DIANE C KILPATRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1057 PAUL MAILLARD RD, SUITE 210, LULING, LA 70070-4349
(985) 785-8200
(985) 785-3779
Mailing address
PO BOX 696, LULING, LA 70070-0696
(985) 785-8200
(985) 785-3779
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
551
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2144E
BLUE CROSS BLUE SHIELD
LA
Enumeration date
10/26/2006
Last updated
07/08/2007
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