Provider Demographics
NPI:1114570843
Name:KING BARRICKLOW, MEGAN CLARE (OT)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:CLARE
Last Name:KING BARRICKLOW
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:
Other - Last Name:KING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:4325 STATE ROUTE 51 N
Mailing Address - Street 2:
Mailing Address - City:ROSTRAVER
Mailing Address - State:PA
Mailing Address - Zip Code:15012
Mailing Address - Country:US
Mailing Address - Phone:800-337-6452
Mailing Address - Fax:724-489-0282
Practice Address - Street 1:3109 UNIVERSITY AVE
Practice Address - Street 2:SUITE C
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505
Practice Address - Country:US
Practice Address - Phone:304-241-4020
Practice Address - Fax:304-241-4029
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-22
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATOC103585225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist