Provider Demographics
NPI:1467604264
Name:KISATCHIE TITLE
Entity Type:Organization
Organization Name:KISATCHIE TITLE
Other - Org Name:CHRISTINA MEHAL, M.A. L.P.C.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:SPARKS
Authorized Official - Last Name:MEHAL
Authorized Official - Suffix:
Authorized Official - Credentials:MA LPC
Authorized Official - Phone:337-824-6226
Mailing Address - Street 1:603 CARY AVE
Mailing Address - Street 2:
Mailing Address - City:JENNINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70546-5229
Mailing Address - Country:US
Mailing Address - Phone:337-824-6226
Mailing Address - Fax:
Practice Address - Street 1:603 CARY AVE
Practice Address - Street 2:
Practice Address - City:JENNINGS
Practice Address - State:LA
Practice Address - Zip Code:70546-5229
Practice Address - Country:US
Practice Address - Phone:337-824-6226
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-13
Last Update Date:2008-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health