Individual
MRS. DOROTHY ANN KIECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
131 DRUMLIN CT, NEWARK, NY 14513-1863
(315) 548-6631
Mailing address
5786 DALTON DR, FARMINGTON, NY 14425-9329
(585) 905-1743
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
004848-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004848-1
STATE LICENCE
NY
Enumeration date
10/03/2011
Last updated
10/03/2011
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