Provider Demographics
NPI:1427899707
Name:BAUDOIN, KORILYN CELEST (MSW)
Entity type:Individual
Prefix:MS
First Name:KORILYN
Middle Name:CELEST
Last Name:BAUDOIN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3422 12TH ST APT A
Mailing Address - Street 2:
Mailing Address - City:GULFPORT
Mailing Address - State:MS
Mailing Address - Zip Code:39501-1600
Mailing Address - Country:US
Mailing Address - Phone:601-347-6077
Mailing Address - Fax:
Practice Address - Street 1:9414 THREE RIVERS RD
Practice Address - Street 2:
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39503-4096
Practice Address - Country:US
Practice Address - Phone:228-305-0955
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-03
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker