Provider Demographics
NPI:1073625844
Name:CURRAN, SEAN G (MS,CCC,SLP)
Entity Type:Individual
Prefix:MR
First Name:SEAN
Middle Name:G
Last Name:CURRAN
Suffix:
Gender:M
Credentials:MS,CCC,SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 93
Mailing Address - Street 2:
Mailing Address - City:KELLOGG
Mailing Address - State:ID
Mailing Address - Zip Code:83837-0093
Mailing Address - Country:US
Mailing Address - Phone:208-512-0269
Mailing Address - Fax:
Practice Address - Street 1:25 JAKOBS GULCH
Practice Address - Street 2:
Practice Address - City:KELLOGG
Practice Address - State:ID
Practice Address - Zip Code:83837
Practice Address - Country:US
Practice Address - Phone:208-512-0269
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDSLP-1201235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IDSLP-1201OtherSTATE LICENSE