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NPI Code Detail

MEDICARE: CHLOE ELISE KIESER MS

MEDICARE: CHLOE ELISE KIESER MS
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1659960292
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHLOE ELISE KIESER MS
Provider Business Mailing Address
First Line : 10900 89TH AVE N STE 2
Second Line :
City : MAPLE GROVE
State : MN
Zip : 55369-4098
Country : US
Telephone Number : 763-200-1071
Fax Number :
Provider Business Practice Location Address
First Line : 10900 89TH AVE N STE 2
Second Line :
City : MAPLE GROVE
State : MN
Zip : 55369-4098
Country : US
Telephone Number : 763-200-1071
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/17/2021
Last Update Date : 08/22/2025

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