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General NPI Number Information
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NPI Number | 1437303120
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Entity Type | Individual
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Provider Name | KIMBERLY MARIE SICHENEDER MS, OTR/L
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Gender | Female
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Dates
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Enumeration Date | 11/09/2008
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Last Update Date | 10/15/2024
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Provider Practice Location Address
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Address Line | 1585 3RD ST
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City | FORT JOHNSON
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State | LA
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Zip | 71459-5102
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Country | US
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Telephone | 337-718-7289
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Fax |
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Provider Business Mailing Address
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Address Line | 14214 JUNIPER BREEZE CT
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City | WILLIS
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State | TX
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Zip | 77318-1450
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Country | US
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Telephone | 530-514-2191
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 118364
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 3494
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License Number State | CA
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