MEDICARE: MEGAN LINDGREN

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	120869	TX

General Provider Information

NPI Number	:	1699384032
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGAN LINDGREN

Provider Business Mailing Address
First Line	:	4426 SEA TAC DR APT 7307
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76155-3029
Country	:	US
Telephone Number	:	608-931-8816
Fax Number	:

Provider Business Practice Location Address
First Line	:	4426 SEA TAC DR APT 7307
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76155-3029
Country	:	US
Telephone Number	:	608-931-8816
Fax Number	:

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

Provider Enumeration Date	:	07/30/2020
Last Update Date	:	07/30/2020

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Directions to “ MEGAN LINDGREN ” Practice Location

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