Provider Demographics
NPI:1508300427
Name:CLARY, MEGAN E (OTA)
Entity Type:Individual
Prefix:MS
First Name:MEGAN
Middle Name:E
Last Name:CLARY
Suffix:
Gender:F
Credentials:OTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5624 STATE ROUTE 1514
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42301-8171
Mailing Address - Country:US
Mailing Address - Phone:270-313-0503
Mailing Address - Fax:
Practice Address - Street 1:1003 BURLEW BLVD
Practice Address - Street 2:STE. C
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42303-1799
Practice Address - Country:US
Practice Address - Phone:270-688-8449
Practice Address - Fax:270-240-4840
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-12
Last Update Date:2016-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY137350224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant