Provider Demographics
NPI:1851725063
Name:ROSSOVSKIJ, MEGAN CABLE (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:CABLE
Last Name:ROSSOVSKIJ
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:410 NEW BRIDGE ST STE 10A
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28540-4700
Mailing Address - Country:US
Mailing Address - Phone:910-347-2212
Mailing Address - Fax:910-347-6003
Practice Address - Street 1:410 NEW BRIDGE ST STE 10A
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28540-4700
Practice Address - Country:US
Practice Address - Phone:910-347-2212
Practice Address - Fax:910-347-6003
Is Sole Proprietor?:No
Enumeration Date:2013-08-23
Last Update Date:2014-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8855225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics