Provider Demographics
NPI:1548317324
Name:MAHONEY, MEAGHAN HART (OTR)
Entity type:Individual
Prefix:MRS
First Name:MEAGHAN
Middle Name:HART
Last Name:MAHONEY
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:MISS
Other - First Name:MEAGHAN
Other - Middle Name:ELIZABETH
Other - Last Name:HART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:17 MEADOWLARK DR
Mailing Address - Street 2:
Mailing Address - City:SEEKONK
Mailing Address - State:MA
Mailing Address - Zip Code:02771-2705
Mailing Address - Country:US
Mailing Address - Phone:508-243-8401
Mailing Address - Fax:
Practice Address - Street 1:593 EDDY ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903-4923
Practice Address - Country:US
Practice Address - Phone:401-444-8661
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI825225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist