Provider Demographics
NPI:1336649300
Name:MCSHEFFERY, MEAGAN LAYNE (COTA)
Entity Type:Individual
Prefix:MRS
First Name:MEAGAN
Middle Name:LAYNE
Last Name:MCSHEFFERY
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 JONAS ST
Mailing Address - Street 2:
Mailing Address - City:SULPHUR SPRINGS
Mailing Address - State:TX
Mailing Address - Zip Code:75482-3520
Mailing Address - Country:US
Mailing Address - Phone:903-439-8108
Mailing Address - Fax:
Practice Address - Street 1:208 JONAS ST
Practice Address - Street 2:
Practice Address - City:SULPHUR SPRINGS
Practice Address - State:TX
Practice Address - Zip Code:75482-3520
Practice Address - Country:US
Practice Address - Phone:903-439-8108
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-16
Last Update Date:2018-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX214733224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant