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General NPI Number Information
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NPI Number | 1447050489
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Entity Type | Individual
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Provider Name | MEGAN CONVERSE OTR/L
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Gender | Female
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Dates
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Enumeration Date | 03/18/2025
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Last Update Date | 03/18/2025
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Provider Practice Location Address
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Address Line | 133 PARK ST
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City | MALONE
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State | NY
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Zip | 12953-1244
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Country | US
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Telephone | 518-483-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 373 LAKE OZONIA RD
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City | SAINT REGIS FALLS
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State | NY
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Zip | 12980-1507
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Country | US
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Telephone |
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 030016
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License Number State | NY
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