Provider Demographics
NPI:1730448895
Name:MILLER, MEGAN (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2907 PLEASANT VALLEY BLVD
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16602-4305
Mailing Address - Country:US
Mailing Address - Phone:814-943-8164
Mailing Address - Fax:814-375-1304
Practice Address - Street 1:5690 SHAFFER ROAD
Practice Address - Street 2:
Practice Address - City:DU BOIS
Practice Address - State:PA
Practice Address - Zip Code:15801
Practice Address - Country:US
Practice Address - Phone:814-943-8164
Practice Address - Fax:814-375-1304
Is Sole Proprietor?:No
Enumeration Date:2012-05-10
Last Update Date:2013-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC011530225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist