Provider Demographics
NPI:1376304725
Name:NUNGESSER, CATHERINE ANN
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:ANN
Last Name:NUNGESSER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85510 HIGHWAY 437
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70435-8117
Mailing Address - Country:US
Mailing Address - Phone:504-206-8558
Mailing Address - Fax:
Practice Address - Street 1:85510 HIGHWAY 437
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70435-8117
Practice Address - Country:US
Practice Address - Phone:504-206-8558
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-22
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty