Provider Demographics
NPI:1033303888
Name:MCCLAREN, MICHELLE R (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:R
Last Name:MCCLAREN
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 1:140 E CORTEZ DR
Mailing Address - Street 2:UNIT 106A
Mailing Address - City:SEDONA
Mailing Address - State:AZ
Mailing Address - Zip Code:86351-9122
Mailing Address - Country:US
Mailing Address - Phone:928-266-3553
Mailing Address - Fax:
Practice Address - Street 1:140 E CORTEZ DR
Practice Address - Street 2:UNIT 106A
Practice Address - City:SEDONA
Practice Address - State:AZ
Practice Address - Zip Code:86351-9122
Practice Address - Country:US
Practice Address - Phone:928-266-3553
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-04
Last Update Date:2011-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3800225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist