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General NPI Number Information
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NPI Number | 1861730517
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Entity Type | Individual
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Provider Name | CAYLA LEIGH MALTER MSW, LCSW
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Gender | Female
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Dates
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Enumeration Date | 01/30/2013
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Last Update Date | 06/14/2024
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Provider Practice Location Address
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Address Line | 3401 BERRYWOOD DR STE 203
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City | COLUMBIA
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State | MO
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Zip | 65201-6515
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Country | US
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Telephone | 573-777-8455
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Fax |
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Provider Business Mailing Address
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Address Line | 2305 SOUTH 65 HIGHWAY, BUILDING A
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City | MARSHALL
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State | MO
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Zip | 65340-3702
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Country | US
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Telephone | 660-886-7800
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Fax | 660-886-3328
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 2014024204
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License Number State | MO
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