Kiley Johnson
Individual provider Active NPI Developmental Therapist · Kooskia, ID
NPI 1932064110 · NPPES record last updated Dec 18, 2025
Key facts
- NPI
- 1932064110
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Developmental Therapist 222Q00000X
- Practice address
- 170 Red Fir Rd
Kooskia, ID 83539-5131 - Phone
- (208) 791-9582
- NPI assigned
- Dec 18, 2025
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmental Therapist | 222Q00000X | ID | Yes |
Addresses
Primary practice location
170 Red Fir Rd
Kooskia, ID 83539-5131
Mailing address
170 Red Fir Rd
Kooskia, ID 83539-5131
Phone (208) 791-9582
Other providers in Kooskia, ID
- Heather Butts
- City of Kooskia
- Clearwater Counseling
- Clearwater Counseling
- Clearwater Valley School District #245
- Syringa General Hospital District C I F
- Cathy Marie Ward
All providers in Kooskia, ID · Developmental Therapist in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 18, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.