Provider Demographics
NPI:1598984908
Name:CORCORAN, MAUREEN BRIDGET (OTR)
Entity Type:Individual
Prefix:MS
First Name:MAUREEN
Middle Name:BRIDGET
Last Name:CORCORAN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13801 E BENSON HWY
Mailing Address - Street 2:
Mailing Address - City:VAIL
Mailing Address - State:AZ
Mailing Address - Zip Code:85641-9074
Mailing Address - Country:US
Mailing Address - Phone:520-879-2086
Mailing Address - Fax:
Practice Address - Street 1:1103 N ELM ST STE 300
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-6312
Practice Address - Country:US
Practice Address - Phone:336-272-6161
Practice Address - Fax:336-271-3724
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2934174400000X
NC7024225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No174400000XOther Service ProvidersSpecialist