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NPI Code Detail

MEDICARE: KAYLA CULLETON

MEDICARE: KAYLA CULLETON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor16291TX
2104100000XSocial Worker104449TX
31041C0700XClinical Social Worker104449TX

General Provider Information

NPI Number : 1033681184
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAYLA CULLETON
Provider Business Mailing Address
First Line : 2146 BELVEDERE CT
Second Line :
City : NEW BRAUNFELS
State : TX
Zip : 78130-2687
Country : US
Telephone Number : 207-513-2733
Fax Number :
Provider Business Practice Location Address
First Line : 5522 LONE STAR PKWY STE 303
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78253-6722
Country : US
Telephone Number : 210-614-4990
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/28/2018
Last Update Date : 06/05/2024

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Directions to “ KAYLA CULLETON ” Practice Location

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