Provider Demographics
NPI:1558739094
Name:KHANDEKAR, MEAGAN MICHAUD (MOT, OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:MEAGAN
Middle Name:MICHAUD
Last Name:KHANDEKAR
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36249 FALCON CREST AVE
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:OH
Mailing Address - Zip Code:44011-1870
Mailing Address - Country:US
Mailing Address - Phone:216-337-4711
Mailing Address - Fax:
Practice Address - Street 1:2303 N RIDGE RD E
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44055-3657
Practice Address - Country:US
Practice Address - Phone:440-233-7113
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-14
Last Update Date:2015-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT.006727225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist