Provider Demographics
NPI:1013337245
Name:DORAN, MEGAN
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:
Last Name:DORAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3699 ALEXANDRIA PIKE SUITE D
Mailing Address - Street 2:
Mailing Address - City:COLD SPRING
Mailing Address - State:KY
Mailing Address - Zip Code:41076
Mailing Address - Country:US
Mailing Address - Phone:859-572-0143
Mailing Address - Fax:859-572-0163
Practice Address - Street 1:3699 ALEXANDRIA PIKE STE D
Practice Address - Street 2:
Practice Address - City:COLD SPRING
Practice Address - State:KY
Practice Address - Zip Code:41076-1789
Practice Address - Country:US
Practice Address - Phone:859-572-0143
Practice Address - Fax:859-572-0163
Is Sole Proprietor?:No
Enumeration Date:2014-04-28
Last Update Date:2016-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYA5479224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant