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Individual

KAYLA LOUISE HEIDELBERG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

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
Update your record

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