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General NPI Number Information
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NPI Number | 1033958368
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Entity Type | Individual
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Provider Name | KATHERINE ELIZABETH ANTLEY PLPC
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Gender | Female
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Dates
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Enumeration Date | 05/24/2024
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Last Update Date | 10/09/2025
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Provider Practice Location Address
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Address Line | 622 RIVERSIDE DR
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City | MONROE
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State | LA
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Zip | 71201-6211
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Country | US
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Telephone | 318-398-0945
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Fax |
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Provider Business Mailing Address
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Address Line | 3248 HIGHWAY 818
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City | RUSTON
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State | LA
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Zip | 71270-1368
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Country | US
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Telephone | 318-514-8529
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | PLC10905
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License Number State | LA
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