MEDICARE: CHLOE JO GRAIF

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
1	106S00000X	Behavior Technician		MN

General Provider Information

NPI Number	:	1205642873
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHLOE JO GRAIF

Provider Business Mailing Address
First Line	:	1821 BASSETT DR STE 103
Second Line	:
City	:	MANKATO
State	:	MN
Zip	:	56001-6223
Country	:	US
Telephone Number	:	507-351-1034
Fax Number	:

Provider Business Practice Location Address
First Line	:	1821 BASSETT DR STE 103
Second Line	:
City	:	MANKATO
State	:	MN
Zip	:	56001-6223
Country	:	US
Telephone Number	:	507-351-1034
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/09/2024
Last Update Date	:	10/23/2025

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Directions to “ CHLOE JO GRAIF ” Practice Location

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