Most Relevant Information
Provider Data
| NPI Number: | 1003447129 |
| Provider Name: | KATIE HARRELL THIBODAUX |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 01/28/2020 |
| Last Updated: | 05/22/2023 |
Provider Practice Location
8326 KELWOOD AVE
BATON ROUGE
LA
708064803
Practice Location Phone/Fax
| Phone: | 9857138562 |
| Fax: |
Provider Mailing Location
8326 KELWOOD AVE
BATON ROUGE
LA
708064803
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |