Provider Demographics
NPI:1578127239
Name:KIEFER, AMBER L (BCBA)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:L
Last Name:KIEFER
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5000 W ASHLAND WAY
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:WI
Mailing Address - Zip Code:53132-8177
Mailing Address - Country:US
Mailing Address - Phone:414-367-2710
Mailing Address - Fax:
Practice Address - Street 1:5000 W ASHLAND WAY
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:WI
Practice Address - Zip Code:53132-8177
Practice Address - Country:US
Practice Address - Phone:414-367-2710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-29
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI287-140103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst