=====================================================
General NPI Number Information
=====================================================
NPI Number | 1972079259
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MORGAN K DEEGAN OTR/L, CHT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/15/2018
-----------------------------------------------------
Last Update Date | 01/15/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 16 WOODBINE LN
-----------------------------------------------------
City | DANVILLE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 17821-8029
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 570-214-7968
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 23 BELLS MILL RD
-----------------------------------------------------
City | ERDENHEIM
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19038-8236
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 267-664-8326
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225XH1200X
-----------------------------------------------------
Taxonomy Name | Hand Occupational Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------