Provider Demographics
NPI:1598858060
Name:CAILLOUET, CATHALEEN MARIE (DC)
Entity Type:Individual
Prefix:MRS
First Name:CATHALEEN
Middle Name:MARIE
Last Name:CAILLOUET
Suffix:
Gender:F
Credentials:DC
Other - Prefix:MS
Other - First Name:CATHALEEN
Other - Middle Name:MARIE
Other - Last Name:SINCAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:10979 COURSEY BLVD STE J
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-0403
Mailing Address - Country:US
Mailing Address - Phone:225-295-9993
Mailing Address - Fax:225-295-9939
Practice Address - Street 1:10979 COURSEY BLVD STE J
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-0403
Practice Address - Country:US
Practice Address - Phone:225-295-9993
Practice Address - Fax:225-295-9939
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1291111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U91138Medicare UPIN
LA4C310Medicare ID - Type Unspecified