Provider Demographics
NPI:1891279493
Name:MEEHAN, ALICIA KATHLYN
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:KATHLYN
Last Name:MEEHAN
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 1:3 RAMAPO CT
Mailing Address - Street 2:
Mailing Address - City:COLTS NECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07722-1824
Mailing Address - Country:US
Mailing Address - Phone:732-865-1433
Mailing Address - Fax:
Practice Address - Street 1:3 RAMAPO CT
Practice Address - Street 2:
Practice Address - City:COLTS NECK
Practice Address - State:NJ
Practice Address - Zip Code:07722-1824
Practice Address - Country:US
Practice Address - Phone:732-865-1433
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-19
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist