Provider Demographics
NPI:1578218301
Name:WHITEHEAD, MEAGAN M (ORT/L)
Entity Type:Individual
Prefix:
First Name:MEAGAN
Middle Name:M
Last Name:WHITEHEAD
Suffix:
Gender:F
Credentials:ORT/L
Other - Prefix:
Other - First Name:MEAGAN
Other - Middle Name:M
Other - Last Name:WHITEHEAD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:15044 S BLACKBOB RD
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-2663
Mailing Address - Country:US
Mailing Address - Phone:913-449-9696
Mailing Address - Fax:
Practice Address - Street 1:15044 S BLACKBOB RD
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-2663
Practice Address - Country:US
Practice Address - Phone:913-449-9696
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-21
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist