Provider Demographics
NPI:1952073215
Name:STEPHENS, MEAGAN LOUISE (OTD, OTR/L)
Entity Type:Individual
Prefix:
First Name:MEAGAN
Middle Name:LOUISE
Last Name:STEPHENS
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:MEAGAN
Other - Middle Name:LOUISE
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1330 CATRON BLVD APT 212
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57701-4054
Mailing Address - Country:US
Mailing Address - Phone:515-418-8782
Mailing Address - Fax:
Practice Address - Street 1:2449 E COLORADO BLVD
Practice Address - Street 2:
Practice Address - City:SPEARFISH
Practice Address - State:SD
Practice Address - Zip Code:57783-3204
Practice Address - Country:US
Practice Address - Phone:605-644-4359
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-04
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1214225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist