Provider Demographics
NPI:1164291753
Name:NIEHAUS, MEGAN JANE (OTR/L)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:JANE
Last Name:NIEHAUS
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 LAKEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:VINCENNES
Mailing Address - State:IN
Mailing Address - Zip Code:47591-3736
Mailing Address - Country:US
Mailing Address - Phone:812-890-6735
Mailing Address - Fax:
Practice Address - Street 1:1813 WILLOW ST STE 1B
Practice Address - Street 2:
Practice Address - City:VINCENNES
Practice Address - State:IN
Practice Address - Zip Code:47591-4279
Practice Address - Country:US
Practice Address - Phone:812-316-0072
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-25
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31008281A225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics