DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: MYKENZIE KLOESS

MEDICARE: MYKENZIE KLOESS
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
1103K00000XBehavior Analyst152001130IL

General Provider Information

NPI Number : 1417729393
Entity Type Code : Individual
Provider Name (Legal Business Name) : MYKENZIE KLOESS
Provider Business Mailing Address
First Line : 411 EDWARDSVILLE RD
Second Line :
City : TROY
State : IL
Zip : 62294-1339
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 411 EDWARDSVILLE RD
Second Line :
City : TROY
State : IL
Zip : 62294-1339
Country : US
Telephone Number : 318-820-2535
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/24/2023
Last Update Date : 07/29/2025

Similar Medicare Providers

1528921459 — BAILEY ANN HARMAN
Practice Location Address:
411 EDWARDSVILLE RD
TROY, IL
62294-1339
Practice Phone: 314-275-0506
Practice Fax:
1629317094 — ADAM NICHOLAS THOMPSON RBT
Practice Location Address:
411 EDWARDSVILLE RD
TROY, IL
62294-1339
Practice Phone: 314-275-0506
Practice Fax:
1275223992 — SHARON LEE LAYESKI RBT
Practice Location Address:
411 EDWARDSVILLE RD
TROY, IL
62294-1339
Practice Phone: 314-275-0506
Practice Fax:
1619755410 — MR. ROSS JOHN HEALEA RBT
Practice Location Address:
411 EDWARDSVILLE RD
TROY, IL
62294-1339
Practice Phone: 314-275-0506
Practice Fax:
1538936919 — PAIGE NEDROW
Practice Location Address:
411 EDWARDSVILLE RD
TROY, IL
62294-1339
Practice Phone: 314-275-0506
Practice Fax:
1194586826 — OLIVIA NADLER
Practice Location Address:
411 EDWARDSVILLE RD
TROY, IL
62294-1339
Practice Phone: 314-820-2535
Practice Fax:

Directions to “ MYKENZIE KLOESS ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.