Healthcare Provider Details

I. General information

NPI: 1396651634
Provider Name (Legal Business Name): MEGAN OWEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

531 OPPORTUNITY WAY
LAGRANGE OH
44050-9016
US

IV. Provider business mailing address

45315 STATE ROUTE 18
WELLINGTON OH
44090-9306
US

V. Phone/Fax

Practice location:
  • Phone: 440-355-2424
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License NumberOTA008646
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: