Healthcare Provider Details

I. General information

NPI: 1538087770
Provider Name (Legal Business Name): CHLOE KIRYAKOZA
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13331 15 MILE RD
STERLING HEIGHTS MI
48312-4210
US

IV. Provider business mailing address

13331 15 MILE RD
STERLING HEIGHTS MI
48312-4210
US

V. Phone/Fax

Practice location:
  • Phone: 586-978-0376
  • Fax:
Mailing address:
  • Phone: 586-978-0376
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: