Individual
MEGEN MICHAEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
500 W LAUREL ST, FRACKVILLE, PA 17931-2018
(570) 874-0696
Mailing address
438 NORTH 10TH STREET, TREVORTON, PA 17881
(570) 809-4921
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
OP009575
PA
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1879251013
N/A
PA
Enumeration date
04/03/2019
Last updated
04/10/2022
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