Provider Demographics
NPI:1770888364
Name:YOUNG, MEGAN CAMIELL (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:CAMIELL
Last Name:YOUNG
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12611 E WOODSPRING ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67226-4510
Mailing Address - Country:US
Mailing Address - Phone:901-493-9079
Mailing Address - Fax:
Practice Address - Street 1:2114 N 127TH ST E
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67206-3003
Practice Address - Country:US
Practice Address - Phone:316-500-8800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-13
Last Update Date:2016-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS17-02902174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist