MEDICARE: KIANA HAENEL

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

General Provider Information

NPI Number	:	1588598817
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIANA HAENEL

Provider Business Mailing Address
First Line	:	W3306 STATE HIGHWAY 64
Second Line	:
City	:	MEDFORD
State	:	WI
Zip	:	54451-9632
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	103 S GIBSON ST
Second Line	:
City	:	MEDFORD
State	:	WI
Zip	:	54451-1622
Country	:	US
Telephone Number	:	715-748-8112
Fax Number	:

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

Provider Enumeration Date	:	06/11/2026
Last Update Date	:	06/11/2026

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Directions to “ KIANA HAENEL ” Practice Location

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