Provider Demographics
NPI:1326559253
Name:MEAHL, JENNA (COTA/L)
Entity type:Individual
Prefix:
First Name:JENNA
Middle Name:
Last Name:MEAHL
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:JENNA
Other - Middle Name:
Other - Last Name:GUNNOE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:COTA/L
Mailing Address - Street 1:2353 FAIRFAX DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:IN
Mailing Address - Zip Code:47203-2285
Mailing Address - Country:US
Mailing Address - Phone:317-512-6353
Mailing Address - Fax:
Practice Address - Street 1:6825 MADISON AVE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46227-5168
Practice Address - Country:US
Practice Address - Phone:317-851-8419
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-18
Last Update Date:2025-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN32003231A224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant