Individual
CASSANDRA JOAN KIECHLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
149 N MAIN ST, FAIRPORT, NY 14450-1434
(585) 377-2230
(585) 377-2243
Mailing address
190 PARRISH ST # 1A-3, CANANDAIGUA, NY 14424-1724
(315) 767-4543
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
026366-01
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
026366-01
NEW YORK STATE EDUCATION DEPARTMENT
NY
01
—
464409
THE NATIONAL BOARD FOR CERTIFICATION IN OCCUPATIONAL THERAPY, INC.
—
Enumeration date
12/13/2021
Last updated
12/13/2021
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