Provider Demographics
NPI:1710718606
Name:ISTRE, CATINA R (CIT-5707)
Entity type:Individual
Prefix:
First Name:CATINA
Middle Name:R
Last Name:ISTRE
Suffix:
Gender:F
Credentials:CIT-5707
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5329 DIJON DR STE 103
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-4378
Mailing Address - Country:US
Mailing Address - Phone:337-520-5205
Mailing Address - Fax:000-000-0000
Practice Address - Street 1:5329 DIJON DR STE 103
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-4378
Practice Address - Country:US
Practice Address - Phone:337-520-5205
Practice Address - Fax:000-000-0000
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-12
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LACIT-5707101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)