Healthcare Provider Details

I. General information

NPI: 1033040886
Provider Name (Legal Business Name): TRENIDY JAYNE MILLIKEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8760 MONROVIA ST
LENEXA KS
66215-3537
US

IV. Provider business mailing address

3103 S BLACK FOREST AVE
BLUE SPRINGS MO
64015-1119
US

V. Phone/Fax

Practice location:
  • Phone: 916-214-2677
  • Fax:
Mailing address:
  • Phone: 816-752-2996
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: