MEDICARE: KAYLA NICOLE KRUEL

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	103K00000X	Behavior Analyst	1-26-87493	MO

General Provider Information

NPI Number	:	1437757366
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAYLA NICOLE KRUEL

Provider Business Mailing Address
First Line	:	115 PIPER HILL DR
Second Line	:
City	:	SAINT PETERS
State	:	MO
Zip	:	63376-2589
Country	:	US
Telephone Number	:	619-795-9925
Fax Number	:

Provider Business Practice Location Address
First Line	:	115 PIPER HILL DR
Second Line	:
City	:	SAINT PETERS
State	:	MO
Zip	:	63376-2589
Country	:	US
Telephone Number	:	573-208-7700
Fax Number	:

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

Provider Enumeration Date	:	10/13/2020
Last Update Date	:	02/18/2026

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