Provider Demographics
NPI:1992680417
Name:BANNISTER, MEAGHAN ASHLEY (OTD, OTR/L)
Entity type:Individual
Prefix:
First Name:MEAGHAN
Middle Name:ASHLEY
Last Name:BANNISTER
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9020 SENCA DR STE 220
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28411-6680
Mailing Address - Country:US
Mailing Address - Phone:910-264-2317
Mailing Address - Fax:
Practice Address - Street 1:9020 SENCA DR STE 220
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28411-6680
Practice Address - Country:US
Practice Address - Phone:910-264-9317
Practice Address - Fax:910-442-8372
Is Sole Proprietor?:No
Enumeration Date:2025-08-06
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC17867225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics