Provider Demographics
NPI:1821794108
Name:PALMER, CAILA MONET
Entity Type:Individual
Prefix:
First Name:CAILA
Middle Name:MONET
Last Name:PALMER
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 1:2053 GAUSE BLVD E STE 150
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70461-5451
Mailing Address - Country:US
Mailing Address - Phone:985-649-1001
Mailing Address - Fax:985-646-1005
Practice Address - Street 1:2053 GAUSE BLVD E STE 150
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70461-5451
Practice Address - Country:US
Practice Address - Phone:985-649-1001
Practice Address - Fax:985-646-1005
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-07
Last Update Date:2023-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA011633348101Y00000X, 171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101Y00000XBehavioral Health & Social Service ProvidersCounselor