Provider Demographics
NPI:1043437007
Name:MORAN, CLAUDIA GAIL (MS OTRL)
Entity Type:Individual
Prefix:MRS
First Name:CLAUDIA
Middle Name:GAIL
Last Name:MORAN
Suffix:
Gender:F
Credentials:MS OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 HORSESHOE DR
Mailing Address - Street 2:
Mailing Address - City:SHERWOOD
Mailing Address - State:AR
Mailing Address - Zip Code:72120-3433
Mailing Address - Country:US
Mailing Address - Phone:501-416-8317
Mailing Address - Fax:
Practice Address - Street 1:108 HORSESHOE DR
Practice Address - Street 2:
Practice Address - City:SHERWOOD
Practice Address - State:AR
Practice Address - Zip Code:72120-3433
Practice Address - Country:US
Practice Address - Phone:501-833-2698
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2012-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROTR935225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR127718721Medicaid