Provider Demographics
NPI:1578082004
Name:MCGEGGEN, ERIN M (OTR/L)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:M
Last Name:MCGEGGEN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 SEMINARY HL APT 34D
Mailing Address - Street 2:
Mailing Address - City:WEST LEBANON
Mailing Address - State:NH
Mailing Address - Zip Code:03784-1718
Mailing Address - Country:US
Mailing Address - Phone:781-654-1316
Mailing Address - Fax:
Practice Address - Street 1:49 LYME RD
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:NH
Practice Address - Zip Code:03755-1205
Practice Address - Country:US
Practice Address - Phone:603-643-2854
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-15
Last Update Date:2017-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT072.0132711225X00000X
NH2697225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist