MEDICARE: ANNETTE SOPHIE KIELB MOT, 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	5201013751	MI

General Provider Information

NPI Number	:	1144170762
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNETTE SOPHIE KIELB MOT, OTR

Provider Business Mailing Address
First Line	:	2808 GROVES DR
Second Line	:
City	:	STERLING HEIGHTS
State	:	MI
Zip	:	48310-3629
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2808 GROVES DR
Second Line	:
City	:	STERLING HEIGHTS
State	:	MI
Zip	:	48310-3629
Country	:	US
Telephone Number	:	586-744-5430
Fax Number	:

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

Provider Enumeration Date	:	02/02/2026
Last Update Date	:	02/02/2026

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