Provider Demographics
NPI:1659573251
Name:CORCORAN, JEANNE SHEEHAN (OTRL)
Entity Type:Individual
Prefix:MS
First Name:JEANNE
Middle Name:SHEEHAN
Last Name:CORCORAN
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 LILAC MEADOWS WAY
Mailing Address - Street 2:
Mailing Address - City:IPSWICH
Mailing Address - State:MA
Mailing Address - Zip Code:01938-1289
Mailing Address - Country:US
Mailing Address - Phone:978-312-1275
Mailing Address - Fax:
Practice Address - Street 1:403 LILAC MEADOWS WAY
Practice Address - Street 2:
Practice Address - City:IPSWICH
Practice Address - State:MA
Practice Address - Zip Code:01938-1289
Practice Address - Country:US
Practice Address - Phone:978-312-1275
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1464225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist