Provider Demographics
NPI:1386903524
Name:MACHADO, MEGAN LEIGH (OTR/L)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:LEIGH
Last Name:MACHADO
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 DAMREN RD
Mailing Address - Street 2:
Mailing Address - City:DERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03038-5610
Mailing Address - Country:US
Mailing Address - Phone:978-302-5999
Mailing Address - Fax:
Practice Address - Street 1:42 DAMREN RD
Practice Address - Street 2:
Practice Address - City:DERRY
Practice Address - State:NH
Practice Address - Zip Code:03038-5610
Practice Address - Country:US
Practice Address - Phone:978-302-5999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-09
Last Update Date:2012-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2075225X00000X
MA9712225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist