Individual
KATHLEEN MARY POWERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
900 WILKINSON ST, MANDEVILLE, LA 70448-3533
(985) 624-4456
Mailing address
900 WILKINSON ST, MANDEVILLE, LA 70448-3533
(985) 624-4456
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
LA
175T00000X
Peer Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1154750644
—
LA
Enumeration date
09/30/2020
Last updated
03/30/2021
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