Healthcare Provider Details

I. General information

NPI: 1083537054
Provider Name (Legal Business Name): KYNDAL HAWKIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2551 TOWER DR STE 3
MONROE LA
71201-5779
US

IV. Provider business mailing address

2329 EDENBORN AVE
METAIRIE LA
70001-1815
US

V. Phone/Fax

Practice location:
  • Phone: 318-660-1111
  • Fax: 318-383-1014
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberLA10452
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: