Healthcare Provider Details

I. General information

NPI: 1548317324
Provider Name (Legal Business Name): MEAGHAN HART MAHONEY OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MEAGHAN ELIZABETH HART OTR

II. Dates (important events)

Enumeration Date: 01/04/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

593 EDDY ST
PROVIDENCE RI
02903-4923
US

IV. Provider business mailing address

17 MEADOWLARK DR
SEEKONK MA
02771-2705
US

V. Phone/Fax

Practice location:
  • Phone: 401-444-8661
  • Fax:
Mailing address:
  • Phone: 508-243-8401
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number825
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: