| NPI | 1073984266 | 
|---|---|
| Professional Name | KIM WISE GASTINELL | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 3747P1801X Technician, Personal Care Attendant | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: LA 47-5122250)  | 
| Enumeration Date | 2015-10-13 | 
| Last Update Date | 2022-03-24 |