Provider Demographics
NPI:1730606385
Name:SCHLOSSER, MEGAN LEANN
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:LEANN
Last Name:SCHLOSSER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 FLOYD DR.
Mailing Address - Street 2:
Mailing Address - City:SIKESTON
Mailing Address - State:MO
Mailing Address - Zip Code:63801
Mailing Address - Country:US
Mailing Address - Phone:573-472-0397
Mailing Address - Fax:
Practice Address - Street 1:KENNY ROGERS CHILDREN'S CENTER
Practice Address - Street 2:300 FLOYD DR.
Practice Address - City:SIKESTON
Practice Address - State:MO
Practice Address - Zip Code:63801
Practice Address - Country:US
Practice Address - Phone:573-472-0397
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-24
Last Update Date:2017-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015004122224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant