Healthcare Provider Details

I. General information

NPI: 1508780628
Provider Name (Legal Business Name): MEGAN GUCKEEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 S PARK ST
MADISON WI
53715-1507
US

IV. Provider business mailing address

202 S PARK ST
MADISON WI
53715-1507
US

V. Phone/Fax

Practice location:
  • Phone: 608-417-7546
  • Fax: 608-417-6571
Mailing address:
  • Phone: 608-417-7546
  • Fax: 608-417-6571

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number9250
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: