Provider Demographics
NPI:1386130706
Name:VANHEERDE, MEGAN LEANN (OTD)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:LEANN
Last Name:VANHEERDE
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:LEANN
Other - Last Name:RUEB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4029 S HOMERUN AVE
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57110-4853
Mailing Address - Country:US
Mailing Address - Phone:605-660-4169
Mailing Address - Fax:
Practice Address - Street 1:1000 N WEST AVE STE 210
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57104-1314
Practice Address - Country:US
Practice Address - Phone:605-231-2490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-09
Last Update Date:2018-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist