Provider Demographics
NPI:1043748890
Name:FITCH, MEGAN (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:
Last Name:FITCH
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:
Other - Last Name:CASSIDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:6165 WALNUT LN UNIT 92
Mailing Address - Street 2:
Mailing Address - City:CUDAHY
Mailing Address - State:WI
Mailing Address - Zip Code:53110-3467
Mailing Address - Country:US
Mailing Address - Phone:224-399-5463
Mailing Address - Fax:
Practice Address - Street 1:800 WALL ST
Practice Address - Street 2:
Practice Address - City:ELM GROVE
Practice Address - State:WI
Practice Address - Zip Code:53122-2631
Practice Address - Country:US
Practice Address - Phone:262-282-8459
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-24
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6092-26225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist