Individual
KAITLYN ALICE FORMHALS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, PLPC, PLMFT
Contact information
Practice address
1105 HUDSON LN, MONROE, LA 71201-6003
(318) 322-6500
Mailing address
314 CEDARBROOK DR, MONROE, LA 71203-2986
(406) 261-7060
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
PLC10782
LA
106H00000X
Marriage & Family Therapist
Primary
PLM1596
LA
Other
Enumeration date
06/23/2025
Last updated
06/23/2025
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