MEDICARE: KYLEE KNUTSON

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

General Provider Information

NPI Number	:	1487513198
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KYLEE KNUTSON

Provider Business Mailing Address
First Line	:	6700 S VERRADO WAY
Second Line	:
City	:	BUCKEYE
State	:	AZ
Zip	:	85326-5680
Country	:	US
Telephone Number	:	623-680-9105
Fax Number	:

Provider Business Practice Location Address
First Line	:	5150 N 99TH AVE
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85305-3001
Country	:	US
Telephone Number	:	623-680-9105
Fax Number	:

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

Provider Enumeration Date	:	01/19/2026
Last Update Date	:	01/19/2026

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Directions to “ KYLEE KNUTSON ” Practice Location

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