Healthcare Provider Details

I. General information

NPI: 1336677673
Provider Name (Legal Business Name): MEGAN METCALF OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2017
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

850 LADD RD BLDG D
WALLED LAKE MI
48390-3019
US

IV. Provider business mailing address

375 NEPTUNE DR
WALLED LAKE MI
48390-3664
US

V. Phone/Fax

Practice location:
  • Phone: 248-956-2000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number6125
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number5201010936
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: