Provider Demographics
NPI:1740217983
Name:PERRY, MEGAN MARIE (OTR)
Entity Type:Individual
Prefix:MISS
First Name:MEGAN
Middle Name:MARIE
Last Name:PERRY
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 1:2032 BENEDICT CIR
Mailing Address - Street 2:
Mailing Address - City:SAINT ALBANS
Mailing Address - State:WV
Mailing Address - Zip Code:25177-3858
Mailing Address - Country:US
Mailing Address - Phone:304-722-0265
Mailing Address - Fax:
Practice Address - Street 1:BARRON DRIVE
Practice Address - Street 2:
Practice Address - City:INSTITUTE
Practice Address - State:WV
Practice Address - Zip Code:25112-1004
Practice Address - Country:US
Practice Address - Phone:304-766-4848
Practice Address - Fax:304-766-4937
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1261225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV1261OtherWV BD OF OT
MD208897OtherNATL BD CERT IN OT