Provider Demographics
NPI:1972550242
Name:YOUNG, SEAN C (OT)
Entity type:Individual
Prefix:
First Name:SEAN
Middle Name:C
Last Name:YOUNG
Suffix:
Gender:M
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1455 WRIGHT AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:CROWLEY
Mailing Address - State:LA
Mailing Address - Zip Code:70526-2220
Mailing Address - Country:US
Mailing Address - Phone:337-788-1480
Mailing Address - Fax:337-788-0354
Practice Address - Street 1:1455 WRIGHT AVE
Practice Address - Street 2:SUITE A
Practice Address - City:CROWLEY
Practice Address - State:LA
Practice Address - Zip Code:70526-2220
Practice Address - Country:US
Practice Address - Phone:337-788-1480
Practice Address - Fax:337-788-0354
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-30
Last Update Date:2011-06-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LAZ12134225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist