Healthcare Provider Details

I. General information

NPI: 1144955337
Provider Name (Legal Business Name): AMBER STOLTZE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMBER SCHUBERT

II. Dates (important events)

Enumeration Date: 07/21/2022
Last Update Date: 01/22/2026
Certification Date: 01/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 1ST ST STE 133
SERGEANT BLUFF IA
51054-8532
US

IV. Provider business mailing address

204 1ST ST STE 133
SERGEANT BLUFF IA
51054-8532
US

V. Phone/Fax

Practice location:
  • Phone: 712-490-8981
  • Fax: 712-215-7979
Mailing address:
  • Phone: 712-490-8981
  • Fax: 712-215-7979

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number115254
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: