Healthcare Provider Details

I. General information

NPI: 1245833730
Provider Name (Legal Business Name): KAPRI A HALTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/18/2020
Last Update Date: 01/04/2021
Certification Date: 01/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4300 S I 10 SERVICE RD W STE 215
METAIRIE LA
70001-7436
US

IV. Provider business mailing address

3928 CLEMATIS ST.
NEW ORLEANS LA
70122-7436
US

V. Phone/Fax

Practice location:
  • Phone: 504-301-9990
  • Fax: 504-265-9370
Mailing address:
  • Phone: 214-620-9017
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: