Provider Demographics
NPI:1376821991
Name:RIEKEN, AMBER DANIELLE (MOT)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:DANIELLE
Last Name:RIEKEN
Suffix:
Gender:F
Credentials:MOT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11022 LAFAYETTE PLZ
Mailing Address - Street 2:1716
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68154-4530
Mailing Address - Country:US
Mailing Address - Phone:308-440-5071
Mailing Address - Fax:
Practice Address - Street 1:3210 N CLARKSON ST
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:NE
Practice Address - Zip Code:68025-2301
Practice Address - Country:US
Practice Address - Phone:402-721-9300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-31
Last Update Date:2011-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE900987225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist