Provider Demographics
NPI:1508221805
Name:HALE, KYTHAIA KIKI (MHS)
Entity Type:Individual
Prefix:MS
First Name:KYTHAIA
Middle Name:KIKI
Last Name:HALE
Suffix:
Gender:F
Credentials:MHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8517 HICKORY ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70118-2143
Mailing Address - Country:US
Mailing Address - Phone:504-884-9449
Mailing Address - Fax:
Practice Address - Street 1:2140 SAINT BERNARD AVE
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-1613
Practice Address - Country:US
Practice Address - Phone:504-943-1857
Practice Address - Fax:504-943-1858
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-31
Last Update Date:2019-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator