Healthcare Provider Details

I. General information

NPI: 1851858377
Provider Name (Legal Business Name): MEGAN NALLEY OT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MEGAN L MCGAHA

II. Dates (important events)

Enumeration Date: 02/21/2019
Last Update Date: 07/25/2023
Certification Date: 07/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 AUTUMN RD
LITTLE ROCK AR
72211-3606
US

IV. Provider business mailing address

4301 W MARKHAM ST # 783
LITTLE ROCK AR
72205-7101
US

V. Phone/Fax

Practice location:
  • Phone: 501-320-7776
  • Fax: 501-320-7975
Mailing address:
  • Phone: 501-686-8000
  • Fax: 501-526-5148

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOTR3269
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: