Individual
KATHERINE B GRISTINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LOTR, C/NDT
Contact information
Practice address
2 CHANDON CT, MANDEVILLE, LA 70448-3458
(985) 869-3650
Mailing address
2 CHANDON CT, MANDEVILLE, LA 70448-3458
(985) 869-3650
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTT.200107
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
208577
LICENSE NUMBER
LA
Enumeration date
11/28/2007
Last updated
06/09/2014
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