Provider Demographics
NPI:1205260866
Name:WALTERS, MEGHAN ELISE (COTA/L)
Entity type:Individual
Prefix:
First Name:MEGHAN
Middle Name:ELISE
Last Name:WALTERS
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7818 TOWNSHIP ROAD 498 SE
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:OH
Mailing Address - Zip Code:43782-9747
Mailing Address - Country:US
Mailing Address - Phone:740-603-3544
Mailing Address - Fax:
Practice Address - Street 1:7818 TOWNSHIP ROAD 498 SE
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:OH
Practice Address - Zip Code:43782-9747
Practice Address - Country:US
Practice Address - Phone:740-603-3544
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-30
Last Update Date:2013-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH#05438224ZE0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224ZE0001XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantEnvironmental Modification