Individual
MEGAN DEERHAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
111 E ILLINOIS ST, NEW BADEN, IL 62265-1850
(618) 795-6682
Mailing address
1003 A ST, GERMANTOWN, IL 62245-2031
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.009820
IL
Other
Enumeration date
11/01/2012
Last updated
11/01/2012
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