MEDICARE: SLOAN CAMBRON

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

General Provider Information

NPI Number	:	1619520384
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SLOAN CAMBRON

Provider Business Mailing Address
First Line	:	1336 RILEY DR
Second Line	:
City	:	CARROLLTON
State	:	TX
Zip	:	75007-1140
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4315 HOPKINS AVE
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75209-3026
Country	:	US
Telephone Number	:	501-230-6074
Fax Number	:

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

Provider Enumeration Date	:	07/22/2019
Last Update Date	:	07/22/2019

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Directions to “ SLOAN CAMBRON ” Practice Location

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