Provider Demographics
NPI:1588908099
Name:SWEENEY, MAUREEN ANNE (OTR/L)
Entity type:Individual
Prefix:MS
First Name:MAUREEN
Middle Name:ANNE
Last Name:SWEENEY
Suffix:
Gender:F
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 1:655 S WILLOW ST STE 128
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03103-5723
Mailing Address - Country:US
Mailing Address - Phone:800-995-2673
Mailing Address - Fax:888-979-6551
Practice Address - Street 1:152 SADDLE SHOP RD
Practice Address - Street 2:
Practice Address - City:HILLTOP
Practice Address - State:WV
Practice Address - Zip Code:25855
Practice Address - Country:US
Practice Address - Phone:304-469-2966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-21
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMOT-2023-0238225X00000X
NC16502225X00000X
WV1481225X00000X
TX123940225X00000X
OHOT002678225X00000X
COOT.0008180225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist