MEDICARE: MEGHAN E ROBERTS OTR/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	8706	MA

General Provider Information

NPI Number	:	1255661146
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGHAN E ROBERTS OTR/L

Provider Business Mailing Address
First Line	:	130 JOSIAH NORTON RD
Second Line	:
City	:	CAPE NEDDICK
State	:	ME
Zip	:	03902-7971
Country	:	US
Telephone Number	:	978-815-8160
Fax Number	:

Provider Business Practice Location Address
First Line	:	130 JOSIAH NORTON RD
Second Line	:
City	:	CAPE NEDDICK
State	:	ME
Zip	:	03902-7971
Country	:	US
Telephone Number	:	978-815-8160
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/28/2009
Last Update Date	:	12/28/2009

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