Provider Demographics
NPI:1083307276
Name:OVERFIELD, KASSIDY N
Entity Type:Individual
Prefix:
First Name:KASSIDY
Middle Name:N
Last Name:OVERFIELD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 VOLUSIA DR
Mailing Address - Street 2:
Mailing Address - City:DEBARY
Mailing Address - State:FL
Mailing Address - Zip Code:32713-3231
Mailing Address - Country:US
Mailing Address - Phone:352-801-2976
Mailing Address - Fax:
Practice Address - Street 1:4401 E COLONIAL DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-5227
Practice Address - Country:US
Practice Address - Phone:352-801-2976
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-01
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant