Basic Information
| Provider Information | |||||||||
| NPI: | 1124500848 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | VESEY | ||||||||
| FirstName: | MEGAN | ||||||||
| MiddleName: | KIMBERLY | ||||||||
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| Credential: | OTR/L | ||||||||
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| Mailing Information | |||||||||
| Address1: | 116 LOCUST LN | ||||||||
| Address2: | |||||||||
| City: | WILLOW STREET | ||||||||
| State: | PA | ||||||||
| PostalCode: | 175849562 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7174902259 | ||||||||
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| Practice Location | |||||||||
| Address1: | 6129 PALMETTO ST | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191115729 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2157228555 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/29/2018 | ||||||||
| LastUpdateDate: | 08/29/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | OC015751 | PA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.