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Individual

KRISTINA DEZENDORF

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3415 GERLANDO DR, BATON ROUGE, LA 70814-1109
(225) 610-7400
Mailing address
3415 GERLANDO DR, BATON ROUGE, LA 70814-1109

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
17723
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
842918857
LA
Enumeration date
07/03/2023
Last updated
07/03/2023
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