Provider Demographics
NPI:1659960292
Name:KIESER, CHLOE ELISE (MS)
Entity type:Individual
Prefix:
First Name:CHLOE
Middle Name:ELISE
Last Name:KIESER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10900 89TH AVE N STE 2
Mailing Address - Street 2:
Mailing Address - City:MAPLE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55369-4098
Mailing Address - Country:US
Mailing Address - Phone:763-200-1071
Mailing Address - Fax:
Practice Address - Street 1:10900 89TH AVE N STE 2
Practice Address - Street 2:
Practice Address - City:MAPLE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55369-4098
Practice Address - Country:US
Practice Address - Phone:763-200-1071
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-17
Last Update Date:2025-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health