Healthcare Provider Details

I. General information

NPI: 1851231427
Provider Name (Legal Business Name): KATE LYNN DZINDZIO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2026
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

812 E SAINT MARY BLVD
LAFAYETTE LA
70503-2334
US

IV. Provider business mailing address

1301 SAINT MARY ST
THIBODAUX LA
70301-6527
US

V. Phone/Fax

Practice location:
  • Phone: 985-446-6833
  • Fax: 985-446-6835
Mailing address:
  • Phone: 985-447-7905
  • Fax: 985-447-7907

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberL-1097
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: