MEDICARE: ANNE LOUISE KIENLE OTR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	OC012706	PA

General Provider Information

NPI Number	:	1114103736
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNE LOUISE KIENLE OTR

Provider Business Mailing Address
First Line	:	2408 SPRING ST
Second Line	:
City	:	WEST LAWN
State	:	PA
Zip	:	19609-1626
Country	:	US
Telephone Number	:	610-301-1761
Fax Number	:

Provider Business Practice Location Address
First Line	:	2408 SPRING ST
Second Line	:
City	:	WEST LAWN
State	:	PA
Zip	:	19609-1626
Country	:	US
Telephone Number	:	610-301-1761
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/14/2008
Last Update Date	:	02/23/2014

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