MEDICARE: SEAN C. YOUNG OT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	Z12134	LA

General Provider Information

NPI Number	:	1972550242
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SEAN C. YOUNG OT

Provider Business Mailing Address
First Line	:	1455 WRIGHT AVE
Second Line	:	SUITE A
City	:	CROWLEY
State	:	LA
Zip	:	70526-2220
Country	:	US
Telephone Number	:	337-788-1480
Fax Number	:	337-788-0354

Provider Business Practice Location Address
First Line	:	1455 WRIGHT AVE
Second Line	:	SUITE A
City	:	CROWLEY
State	:	LA
Zip	:	70526-2220
Country	:	US
Telephone Number	:	337-788-1480
Fax Number	:	337-788-0354

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/30/2006
Last Update Date	:	06/30/2011

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Directions to “ SEAN C. YOUNG OT” Practice Location

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