Provider Demographics
NPI:1588297451
Name:BENNETT-HILES, KYLEE MICHELLE
Entity type:Individual
Prefix:
First Name:KYLEE
Middle Name:MICHELLE
Last Name:BENNETT-HILES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:406 E SYCAMORE ST
Mailing Address - Street 2:
Mailing Address - City:KOKOMO
Mailing Address - State:IN
Mailing Address - Zip Code:46901-4825
Mailing Address - Country:US
Mailing Address - Phone:765-865-9427
Mailing Address - Fax:765-865-9428
Practice Address - Street 1:406 E SYCAMORE ST
Practice Address - Street 2:
Practice Address - City:KOKOMO
Practice Address - State:IN
Practice Address - Zip Code:46901-4825
Practice Address - Country:US
Practice Address - Phone:765-865-9427
Practice Address - Fax:765-865-9428
Is Sole Proprietor?:No
Enumeration Date:2020-02-19
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)