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NPI Code Detail

MEDICARE: MS. HAYLEY CHRISTINE WOODALL MSW

MEDICARE: MS. HAYLEY CHRISTINE WOODALL MSW
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
1101Y00000XCounselor
2106S00000XBehavior Technician

General Provider Information

NPI Number : 1063881324
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. HAYLEY CHRISTINE WOODALL MSW
Provider Business Mailing Address
First Line : 2620 FORUM BLVD STE E
Second Line :
City : COLUMBIA
State : MO
Zip : 65203-5454
Country : US
Telephone Number : 417-501-4161
Fax Number : 417-627-5330
Provider Business Practice Location Address
First Line : 2620 FORUM BLVD STE E
Second Line :
City : COLUMBIA
State : MO
Zip : 65203-5454
Country : US
Telephone Number : 417-501-4161
Fax Number : 417-627-5330
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/16/2015
Last Update Date : 02/21/2022

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