Individual
THERESA LOUISE KIEFER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
2600 MOREHOUSE AVE, ELKHART, IN 46517-2552
(574) 295-8800
Mailing address
57773 NEWMAN ST, ELKHART, IN 46516-5901
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32001166A
IN
Other
Enumeration date
07/06/2007
Last updated
07/08/2007
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