Individual
KIMBERLY ANNE LOUSTAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6232 MARKET ST, PHILADELPHIA, PA 19139-2922
(215) 444-7672
(267) 627-5873
Mailing address
PO BOX 746722, ATLANTA, GA 30374-6722
(312) 733-9730
(312) 929-0373
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CW018076
PA
Other
Enumeration date
04/04/2014
Last updated
04/28/2025
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