Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | ||
N | 225XM0800X | Mental Health | ||
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | ||
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | ||
Y | 225XP0200X | Occupational Therapist - Pediatrics |
NPI | 1710204763 |
---|---|
Provider Name | Amber R Kilczewski |
First Address | Olympia, WA 98506-3426 |
Second Address | Olympia, WA 98506-3426 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/04/2010 |
Last Update Date | 25/05/2017 |