Provider Demographics
NPI:1093498446
Name:KIEVE, KELLEY (MOT,OTR/L)
Entity Type:Individual
Prefix:
First Name:KELLEY
Middle Name:
Last Name:KIEVE
Suffix:
Gender:F
Credentials:MOT,OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:902 W HAMILTON ST APT 325
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18101-1319
Mailing Address - Country:US
Mailing Address - Phone:707-321-3316
Mailing Address - Fax:
Practice Address - Street 1:430 NAZARETH PIKE
Practice Address - Street 2:
Practice Address - City:NAZARETH
Practice Address - State:PA
Practice Address - Zip Code:18064-9615
Practice Address - Country:US
Practice Address - Phone:610-365-2437
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-11
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC019244225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist