Provider Demographics
NPI:1225149867
Name:MCCARRON, SEAN PATRICK (OTR/L)
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:PATRICK
Last Name:MCCARRON
Suffix:
Gender:M
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 1:38 KENSINGTON DR
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72034-4850
Mailing Address - Country:US
Mailing Address - Phone:501-329-5159
Mailing Address - Fax:
Practice Address - Street 1:931 LOCUST ST
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72034-5332
Practice Address - Country:US
Practice Address - Phone:501-472-9064
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROTR1543225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist