Provider Demographics
NPI:1437660719
Name:NEILL, MEGAN (OTR/L)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:NEILL
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 1:6059 HASKELL RD
Mailing Address - Street 2:
Mailing Address - City:EFFINGHAM
Mailing Address - State:KS
Mailing Address - Zip Code:66023-5159
Mailing Address - Country:US
Mailing Address - Phone:913-568-5486
Mailing Address - Fax:
Practice Address - Street 1:1419 N 6TH ST
Practice Address - Street 2:
Practice Address - City:ATCHISON
Practice Address - State:KS
Practice Address - Zip Code:66002-1244
Practice Address - Country:US
Practice Address - Phone:913-367-1906
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-13
Last Update Date:2017-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007021083225X00000X
KS17-02964225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist