Individual
AMBER KIECK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
2424 S 90TH ST, WEST ALLIS, WI 53227-2455
(414) 321-2255
(414) 321-2091
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
4736
WI
225XP0019X
Physical Rehabilitation Occupational Therapist
4736-26
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100247870
—
WI
01
—
4736-26
OTR-L
WI
Enumeration date
12/05/2016
Last updated
10/20/2023
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