Individual
MEGAN GOEKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
239 VILLAGE CENTER PKWY STE 190, STOCKBRIDGE, GA 30281-6396
(770) 628-1500
Mailing address
239 VILLAGE CENTER PKWY STE 190, STOCKBRIDGE, GA 30281-6396
(770) 628-1500
(770) 628-1050
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
260261
KY
225X00000X
Occupational Therapist
OT006155
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
260261
KENTUCKY STATE LICENSE
KY
01
—
OT006155
GA STATE LICENSE
GA
Enumeration date
04/01/2015
Last updated
04/27/2023
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