Provider Demographics
NPI:1558240192
Name:CONNELLY, MEGHAN LINDSAY (OTR)
Entity type:Individual
Prefix:
First Name:MEGHAN
Middle Name:LINDSAY
Last Name:CONNELLY
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:252 EL DORADO RD
Mailing Address - Street 2:
Mailing Address - City:JARRELL
Mailing Address - State:TX
Mailing Address - Zip Code:76537-0594
Mailing Address - Country:US
Mailing Address - Phone:830-220-2547
Mailing Address - Fax:
Practice Address - Street 1:3303 NORTHLAND DR STE 312
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-4956
Practice Address - Country:US
Practice Address - Phone:512-291-2669
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-28
Last Update Date:2025-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX125851225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist