MEDICARE: AMBER R ULICKEY

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	9064-26	WI

General Provider Information

NPI Number	:	1871458356
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMBER R ULICKEY

Provider Business Mailing Address
First Line	:	N55W17862 HIGH BLUFF DR UNIT D
Second Line	:
City	:	MENOMONEE FALLS
State	:	WI
Zip	:	53051-1276
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	N14W23800 STONE RIDGE DR STE 110
Second Line	:
City	:	WAUKESHA
State	:	WI
Zip	:	53188-1144
Country	:	US
Telephone Number	:	262-928-8830
Fax Number	:

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

Provider Enumeration Date	:	12/17/2025
Last Update Date	:	12/17/2025

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Directions to “ AMBER R ULICKEY ” Practice Location

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