Provider Demographics
NPI:1750157970
Name:FARRELL, SEAN MICHAEL FRANCIS (CATC 1)
Entity type:Individual
Prefix:
First Name:SEAN
Middle Name:MICHAEL FRANCIS
Last Name:FARRELL
Suffix:
Gender:M
Credentials:CATC 1
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1320 NW HOMESTEAD DR
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73505-5288
Mailing Address - Country:US
Mailing Address - Phone:714-252-3008
Mailing Address - Fax:
Practice Address - Street 1:1320 NW HOMESTEAD DR
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505-5288
Practice Address - Country:US
Practice Address - Phone:714-252-3008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-29
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator