Provider Demographics
NPI:1114570538
Name:ABE, MEGAN B (OTR)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:B
Last Name:ABE
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13554 BONITA AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:34609-3001
Mailing Address - Country:US
Mailing Address - Phone:304-627-9779
Mailing Address - Fax:
Practice Address - Street 1:11820 DENTON AVE
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:FL
Practice Address - Zip Code:34667-5419
Practice Address - Country:US
Practice Address - Phone:727-862-9101
Practice Address - Fax:888-345-5315
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-24
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2056225X00000X
FLOT20943225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist