Provider Demographics
NPI:1861147878
Name:CESTIA, KATIE A (MSPT)
Entity type:Individual
Prefix:MRS
First Name:KATIE
Middle Name:A
Last Name:CESTIA
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:MS
Other - First Name:KATIE
Other - Middle Name:A
Other - Last Name:CHERHONIAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSPT
Mailing Address - Street 1:622 EAST COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70607
Mailing Address - Country:US
Mailing Address - Phone:337-217-4300
Mailing Address - Fax:337-217-4308
Practice Address - Street 1:1302 5TH ST
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70601
Practice Address - Country:US
Practice Address - Phone:337-217-4300
Practice Address - Fax:337-217-4308
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-17
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA06829R225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist