Provider Demographics
NPI:1194073007
Name:KRIEGE, KAYLEE J (SLP)
Entity type:Individual
Prefix:MRS
First Name:KAYLEE
Middle Name:J
Last Name:KRIEGE
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:806 N. WASHINGTON ST.
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58501
Mailing Address - Country:US
Mailing Address - Phone:701-323-4028
Mailing Address - Fax:701-323-4027
Practice Address - Street 1:3835 SUPREME CT NW STE 2
Practice Address - Street 2:
Practice Address - City:BEMIDJI
Practice Address - State:MN
Practice Address - Zip Code:56601-4485
Practice Address - Country:US
Practice Address - Phone:218-444-8280
Practice Address - Fax:218-444-8337
Is Sole Proprietor?:No
Enumeration Date:2012-08-27
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN8985235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist