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General NPI Number Information
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NPI Number | 1093696494
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Entity Type | Individual
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Provider Name | JANET ELAINE MEYDAM MS, OTR/L
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Gender | Female
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Dates
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Enumeration Date | 09/11/2025
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | PO BOX 8
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City | GRANTS
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State | NM
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Zip | 87020-0008
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Country | US
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Telephone | 505-285-2600
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Fax |
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Provider Business Mailing Address
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Address Line | N6756 CARDINAL LN
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City | WITTENBERG
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State | WI
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Zip | 54499-8548
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Country | US
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Telephone | 505-285-2600
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 1434-26
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | OT-2025-0107
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License Number State | NM
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