Healthcare Provider Details

I. General information

NPI: 1184150765
Provider Name (Legal Business Name): MEGAN ELIZABETH STEVENS MHS, OTR L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2017
Last Update Date: 05/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

980 JOHNSON FY RD NE SUITE 1020
ATLANTA GA
30342-1626
US

IV. Provider business mailing address

980 JOHNSON FY RD NE SUITE 1020
ATLANTA GA
30342-1626
US

V. Phone/Fax

Practice location:
  • Phone: 404-255-0226
  • Fax: 404-256-8970
Mailing address:
  • Phone: 404-255-0226
  • Fax: 404-256-8970

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License NumberOTP006298
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: