Provider Demographics
NPI:1154185841
Name:KIEFFENS, EMILY GRACE (OTD, OTR/L)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:GRACE
Last Name:KIEFFENS
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:GRACE
Other - Last Name:KIEFFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTD, OTR/L
Mailing Address - Street 1:6808 SKILLMAN ST APT 2214
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-5816
Mailing Address - Country:US
Mailing Address - Phone:303-889-9960
Mailing Address - Fax:
Practice Address - Street 1:4925 GREENVILLE AVE STE 380
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75206-4026
Practice Address - Country:US
Practice Address - Phone:303-889-9960
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX124275225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist