Provider Demographics
NPI:1861545253
Name:FESSLER, AMBER KENDA (MS, OTR/L)
Entity type:Individual
Prefix:MISS
First Name:AMBER
Middle Name:KENDA
Last Name:FESSLER
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:KENDA
Other - Last Name:MCQUISTION
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, OTR/L
Mailing Address - Street 1:2218 JACKSON BLVD STE 11
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57702-3452
Mailing Address - Country:US
Mailing Address - Phone:605-646-3490
Mailing Address - Fax:605-646-2581
Practice Address - Street 1:2218 JACKSON BLVD STE 11
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57702-3452
Practice Address - Country:US
Practice Address - Phone:605-646-3490
Practice Address - Fax:605-646-2581
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD0637225X00000X
NC6062225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7301915Medicaid