Provider Demographics
NPI:1730434358
Name:DUBOSE, MEGAN FLOYD (OT)
Entity type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:FLOYD
Last Name:DUBOSE
Suffix:
Gender:F
Credentials:OT
Other - Prefix:MISS
Other - First Name:MEGAN
Other - Middle Name:BLANCHE
Other - Last Name:FLOYD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:1185 WILSON HALL RD
Mailing Address - Street 2:
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29150-1842
Mailing Address - Country:US
Mailing Address - Phone:803-469-3213
Mailing Address - Fax:803-469-3233
Practice Address - Street 1:1185 WILSON HALL RD
Practice Address - Street 2:
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29150-1842
Practice Address - Country:US
Practice Address - Phone:803-469-3213
Practice Address - Fax:803-469-3233
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-19
Last Update Date:2016-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3960225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist