Provider Demographics
NPI:1346646536
Name:THOMPSON, MEGAN (COTA/L)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11412 STATE ROUTE 9
Mailing Address - Street 2:
Mailing Address - City:KENSINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:44427-9777
Mailing Address - Country:US
Mailing Address - Phone:330-575-1293
Mailing Address - Fax:
Practice Address - Street 1:3927 38TH ST NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-2900
Practice Address - Country:US
Practice Address - Phone:330-493-0096
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-14
Last Update Date:2014-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOTA.04141224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant