Provider Demographics
NPI:1669239273
Name:GUGLIETTA, MEGHAN (MSOT, OTR/L)
Entity type:Individual
Prefix:MRS
First Name:MEGHAN
Middle Name:
Last Name:GUGLIETTA
Suffix:
Gender:F
Credentials:MSOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2823 ADDISON LN
Mailing Address - Street 2:
Mailing Address - City:JOHNS CREEK
Mailing Address - State:GA
Mailing Address - Zip Code:30005-5051
Mailing Address - Country:US
Mailing Address - Phone:860-810-4242
Mailing Address - Fax:
Practice Address - Street 1:11785 NORTHFALL LN STE 502
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30009-7961
Practice Address - Country:US
Practice Address - Phone:770-569-2274
Practice Address - Fax:770-569-7432
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-29
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT009068225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist