Provider Demographics
NPI:1033303516
Name:CHAPPELL, SEAN
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:
Last Name:CHAPPELL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13385 W MCDOWELL RD
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85395-2631
Mailing Address - Country:US
Mailing Address - Phone:623-986-5110
Mailing Address - Fax:623-207-9683
Practice Address - Street 1:2040 S ALMA SCHOOL RD
Practice Address - Street 2:SUITE 1 PMB 500
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85286-7075
Practice Address - Country:US
Practice Address - Phone:602-323-0894
Practice Address - Fax:602-445-9337
Is Sole Proprietor?:No
Enumeration Date:2007-08-28
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZTSLP5608235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist