Individual
KAYLA LOUISE HEIDELBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1430 OLIVE ST STE 500, SAINT LOUIS, MO 63103-2377
(314) 206-3700
(314) 206-3708
Mailing address
1430 OLIVE ST STE 400, SAINT LOUIS, MO 63103-2303
(314) 206-3700
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0606247782
BSW
MO
Enumeration date
01/10/2018
Last updated
01/10/2018
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