Provider Demographics
NPI:1437773470
Name:GUESS, KATELYN DAWN
Entity Type:Individual
Prefix:
First Name:KATELYN
Middle Name:DAWN
Last Name:GUESS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KATELYN
Other - Middle Name:DAWN
Other - Last Name:BAKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2156 WOODDALE BLVD STE 750
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806-1404
Mailing Address - Country:US
Mailing Address - Phone:225-930-8058
Mailing Address - Fax:
Practice Address - Street 1:2156 WOODDALE BLVD STE 750
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-1404
Practice Address - Country:US
Practice Address - Phone:225-930-8058
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-05
Last Update Date:2020-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator