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NPI Code Detail

MEDICARE: MEGAN NICOLE HAENCHEN OTR/L

MEDICARE: MEGAN NICOLE HAENCHEN OTR/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist2018041222MO

General Provider Information

NPI Number : 1326651431
Entity Type Code : Individual
Provider Name (Legal Business Name) : MEGAN NICOLE HAENCHEN OTR/L
Provider Business Mailing Address
First Line : 13148 BARRETT MEADOWS DR
Second Line :
City : BALLWIN
State : MO
Zip : 63021-3810
Country : US
Telephone Number : 314-956-4608
Fax Number :
Provider Business Practice Location Address
First Line : 11278 SCHUETZ RD
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63146-4957
Country : US
Telephone Number : 314-991-4066
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/28/2020
Last Update Date : 08/28/2020

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