Provider Demographics
NPI:1770153165
Name:DEASON, MEADOW RENEE (OTD, OTR/L)
Entity type:Individual
Prefix:DR
First Name:MEADOW
Middle Name:RENEE
Last Name:DEASON
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2110 HEAVENLY VIEW TRL
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89523-6886
Mailing Address - Country:US
Mailing Address - Phone:775-232-6359
Mailing Address - Fax:
Practice Address - Street 1:491 COURT ST
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89501-1708
Practice Address - Country:US
Practice Address - Phone:775-525-8103
Practice Address - Fax:775-525-8105
Is Sole Proprietor?:No
Enumeration Date:2021-06-28
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV2286225XF0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XF0002XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistFeeding, Eating & Swallowing