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Individual

MRS. KATHERINE LEA GRISTINA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CCC-SLP

Contact information

Practice address
307 COPAL STREET, MANDEVILLE, LA 70448
(504) 874-1090
Mailing address
307 COPAL ST, MANDEVILLE, LA 70448-4501
(504) 874-1090

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7065
LA

Other

Enumeration date
06/08/2017
Last updated
07/21/2022
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