Healthcare Provider Details

I. General information

NPI: 1962315101
Provider Name (Legal Business Name): KAYELA MALEWITZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3900 S OLD HIGHWAY 94 STE 3
SAINT CHARLES MO
63304-2800
US

IV. Provider business mailing address

1445 S 18TH ST APT 204
SAINT LOUIS MO
63104-2561
US

V. Phone/Fax

Practice location:
  • Phone: 314-744-9535
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: