Healthcare Provider Details

I. General information

NPI: 1962230854
Provider Name (Legal Business Name): KATIE LAATSCH PLPC
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2024
Last Update Date: 07/23/2024
Certification Date: 07/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4100 S SHERWOOD FOREST BLVD STE 201
BATON ROUGE LA
70816-0008
US

IV. Provider business mailing address

38105 POST OFFICE RD STE 8
PRAIRIEVILLE LA
70769-4296
US

V. Phone/Fax

Practice location:
  • Phone: 225-402-2436
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPLC10309
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: