Provider Demographics
NPI:1164728242
Name:YOUNG, MEGAN KUNIKO (MA, OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:KUNIKO
Last Name:YOUNG
Suffix:
Gender:F
Credentials:MA, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 SALINAS DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89014-3574
Mailing Address - Country:US
Mailing Address - Phone:818-515-8267
Mailing Address - Fax:
Practice Address - Street 1:2520 SAINT ROSE PKWY STE H2-216
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-7783
Practice Address - Country:US
Practice Address - Phone:702-268-8513
Practice Address - Fax:702-852-0430
Is Sole Proprietor?:No
Enumeration Date:2011-02-07
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVOT-3229225X00000X
CA11600225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics