Provider Demographics
NPI:1598199036
Name:MCDANIEL, MORGANN (OTR/L)
Entity Type:Individual
Prefix:
First Name:MORGANN
Middle Name:
Last Name:MCDANIEL
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:PO BOX 441146
Mailing Address - Street 2:APT. 2
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30160-9522
Mailing Address - Country:US
Mailing Address - Phone:678-459-3745
Mailing Address - Fax:
Practice Address - Street 1:1775 HIGHWAY 2392
Practice Address - Street 2:APT. 2
Practice Address - City:CORBIN
Practice Address - State:KY
Practice Address - Zip Code:40701-5117
Practice Address - Country:US
Practice Address - Phone:606-813-6487
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-01
Last Update Date:2016-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY133786225X00000X
KYR5655225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist