Provider Demographics
NPI:1326295460
Name:GONZALEZ, MEGAN COX (DPT)
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:COX
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MISS
Other - First Name:MEGAN
Other - Middle Name:FIELDING
Other - Last Name:COX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1701 LIBRARY BLVD SUITE A
Mailing Address - Street 2:COLLABORATING FOR KIDS, LLC
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46142
Mailing Address - Country:US
Mailing Address - Phone:614-840-0558
Mailing Address - Fax:614-840-9310
Practice Address - Street 1:1701 LIBRARY BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46142
Practice Address - Country:US
Practice Address - Phone:317-881-9923
Practice Address - Fax:614-840-9310
Is Sole Proprietor?:No
Enumeration Date:2008-08-20
Last Update Date:2013-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT 0121452251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2642626Medicaid