Provider Demographics
NPI:1174146161
Name:GRIFFIN, MEGAN (COTA)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:
Other - Last Name:LEACH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:333 GRANADA CT
Mailing Address - Street 2:
Mailing Address - City:LA HABRA
Mailing Address - State:CA
Mailing Address - Zip Code:90631-4433
Mailing Address - Country:US
Mailing Address - Phone:562-565-0326
Mailing Address - Fax:
Practice Address - Street 1:9710 ARTESIA BLVD
Practice Address - Street 2:
Practice Address - City:BELLFLOWER
Practice Address - State:CA
Practice Address - Zip Code:90706-6638
Practice Address - Country:US
Practice Address - Phone:562-925-2274
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-25
Last Update Date:2020-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4609224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant