Healthcare Provider Details

I. General information

NPI: 1720049083
Provider Name (Legal Business Name): KIRSTEN WILLIAMS SCHWEHM PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/28/2006
Last Update Date: 06/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2223 QUAIL RUN STE H1
BATON ROUGE LA
70808
US

IV. Provider business mailing address

2223 QUAIL RUN STE H1
BATON ROUGE LA
70808-9063
US

V. Phone/Fax

Practice location:
  • Phone: 225-366-8098
  • Fax: 888-520-4215
Mailing address:
  • Phone: 225-366-8098
  • Fax: 888-520-4215

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number896
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number896
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: