Provider Demographics
NPI:1952599888
Name:RUSSELL, MEGAN J (OT)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:J
Last Name:RUSSELL
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:
Other - Last Name:LEON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:90 E MAIN ST STE A
Mailing Address - Street 2:
Mailing Address - City:SYLVA
Mailing Address - State:NC
Mailing Address - Zip Code:28779-3030
Mailing Address - Country:US
Mailing Address - Phone:828-631-3009
Mailing Address - Fax:828-354-0209
Practice Address - Street 1:594 CENTENNIAL DR
Practice Address - Street 2:
Practice Address - City:CULLOWHEE
Practice Address - State:NC
Practice Address - Zip Code:28723-1589
Practice Address - Country:US
Practice Address - Phone:828-550-3923
Practice Address - Fax:828-354-0209
Is Sole Proprietor?:No
Enumeration Date:2007-10-04
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10583225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist