Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | ||
N | 101YM0800X | Mental Health Counselor |
NPI | 1003342601 |
---|---|
Provider Name | Kristin Kendrick |
First Address | Metairie, LA 70006-2718 |
Second Address | New Orleans, LA 70119-7561 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2017 |
Last Update Date | 15/10/2018 |