Provider Demographics
NPI:1649446261
Name:CLASSEN, MEGAN (MS, OTR/L, CLT)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:CLASSEN
Suffix:
Gender:F
Credentials:MS, OTR/L, CLT
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:
Other - Last Name:KOTZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 34669
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68134-0669
Mailing Address - Country:US
Mailing Address - Phone:402-932-6791
Mailing Address - Fax:402-614-7835
Practice Address - Street 1:2436 N 48TH ST STE 101
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68504-3627
Practice Address - Country:US
Practice Address - Phone:402-325-6341
Practice Address - Fax:402-488-0056
Is Sole Proprietor?:No
Enumeration Date:2008-05-03
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD0688225X00000X
NE1363225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD0688OtherLICENSE
NE1363OtherNEBRASKA OT LICENSE