Provider Demographics
NPI:1245608504
Name:DEFEBO, MEGAN ANN (OTR/L, ATP)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:ANN
Last Name:DEFEBO
Suffix:
Gender:F
Credentials:OTR/L, ATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:426 LEAVITT ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15226-1122
Mailing Address - Country:US
Mailing Address - Phone:412-491-7213
Mailing Address - Fax:412-491-7213
Practice Address - Street 1:426 LEAVITT ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15226-1122
Practice Address - Country:US
Practice Address - Phone:412-491-7213
Practice Address - Fax:412-491-7213
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-03
Last Update Date:2020-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC013842225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist