Provider Demographics
NPI:1952867897
Name:KEISER, AIMEE LOUISE (OT)
Entity Type:Individual
Prefix:
First Name:AIMEE
Middle Name:LOUISE
Last Name:KEISER
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:851 HILLER RD
Mailing Address - Street 2:
Mailing Address - City:MCKINLEYVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95519-3341
Mailing Address - Country:US
Mailing Address - Phone:707-840-9498
Mailing Address - Fax:
Practice Address - Street 1:851 HILLER RD
Practice Address - Street 2:
Practice Address - City:MCKINLEYVILLE
Practice Address - State:CA
Practice Address - Zip Code:95519-3341
Practice Address - Country:US
Practice Address - Phone:707-840-9498
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-15
Last Update Date:2019-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA90045225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist