Provider Demographics
NPI:1669039574
Name:HARKNESS, MEGHAN LOUISE (OTR)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:LOUISE
Last Name:HARKNESS
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1105 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BEECH GROVE
Mailing Address - State:IN
Mailing Address - Zip Code:46107-1521
Mailing Address - Country:US
Mailing Address - Phone:317-997-4529
Mailing Address - Fax:
Practice Address - Street 1:580 E CARMEL DR STE 320
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-3317
Practice Address - Country:US
Practice Address - Phone:317-564-8332
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-27
Last Update Date:2019-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31006892A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist