Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | OT010000632 | DC |
Y | 225XP0200X | Occupational Therapist - Pediatrics | 08320 | MD |
N | 225XP0200X | Occupational Therapist - Pediatrics | 9795 | MA |
NPI | 1033343447 |
---|---|
Provider Name | Ms. Megan Eileen Jillella |
First Address | Kensington, MD 20895-1009 |
Second Address | Kensington, MD 20895-1009 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/05/2009 |
Last Update Date | 17/03/2018 |