Provider Demographics
NPI:1003363573
Name:STEPHENSON, MEAGIN KNIGHT
Entity Type:Individual
Prefix:MRS
First Name:MEAGIN
Middle Name:KNIGHT
Last Name:STEPHENSON
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 1:2395 LAFAYETTE AVE
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-1316
Mailing Address - Country:US
Mailing Address - Phone:912-278-0087
Mailing Address - Fax:
Practice Address - Street 1:1850 LEE ROAD #134
Practice Address - Street 2:LEE WORLD CENTER
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789
Practice Address - Country:US
Practice Address - Phone:407-389-4357
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT17836225X00000X
GAOT005000225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist