Provider Demographics
NPI:1154565919
Name:MEANGER, VIVIENNE CAROL (MHS, OTR/L)
Entity type:Individual
Prefix:
First Name:VIVIENNE
Middle Name:CAROL
Last Name:MEANGER
Suffix:
Gender:F
Credentials:MHS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7803 E MARQUISE DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85715-3773
Mailing Address - Country:US
Mailing Address - Phone:520-977-8924
Mailing Address - Fax:520-721-4948
Practice Address - Street 1:7803 E MARQUISE DR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85715-3773
Practice Address - Country:US
Practice Address - Phone:520-977-8924
Practice Address - Fax:520-721-4948
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-23
Last Update Date:2009-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2363225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist