Provider Demographics
NPI:1033326475
Name:KASINO, TERRY LYNN (PTA)
Entity Type:Individual
Prefix:
First Name:TERRY
Middle Name:LYNN
Last Name:KASINO
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9888 E VASSAR DR
Mailing Address - Street 2:I-102
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80231-5913
Mailing Address - Country:US
Mailing Address - Phone:720-281-0661
Mailing Address - Fax:
Practice Address - Street 1:7200 S ALTON WAY
Practice Address - Street 2:SUITE B-110
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-2201
Practice Address - Country:US
Practice Address - Phone:720-489-0790
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8110174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist