Healthcare Provider Details

I. General information

NPI: 1255246112
Provider Name (Legal Business Name): KATHERINE HOLLANDER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 BULLDOG DR
MANDEVILLE LA
70471-6101
US

IV. Provider business mailing address

100 BULLDOG DR
MANDEVILLE LA
70471-6101
US

V. Phone/Fax

Practice location:
  • Phone: 985-892-7112
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number19427
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: