Healthcare Provider Details

I. General information

NPI: 1891421822
Provider Name (Legal Business Name): MEGAN OGLESBY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2022
Last Update Date: 06/04/2024
Certification Date: 06/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4335 BRAMBLETON AVE
CAVE SPRING VA
24018-3404
US

IV. Provider business mailing address

4335 BRAMBLETON AVE
CAVE SPRING VA
24018-3404
US

V. Phone/Fax

Practice location:
  • Phone: 540-384-1677
  • Fax:
Mailing address:
  • Phone: 540-384-1677
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberRBT-22-221100
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number18577
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: