Provider Demographics
NPI:1154797264
Name:CRANE, MEGAN MARIE (OT)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:MARIE
Last Name:CRANE
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:MARIE
Other - Last Name:HANSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12630 E LYNNE ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67207-4414
Mailing Address - Country:US
Mailing Address - Phone:316-305-2380
Mailing Address - Fax:
Practice Address - Street 1:1603 N CHAPEL HILL ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67206-5506
Practice Address - Country:US
Practice Address - Phone:316-440-6551
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-12
Last Update Date:2016-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KST-04350225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist