Provider Demographics
NPI:1093923484
Name:CASS, JARED S (OTRL)
Entity Type:Individual
Prefix:MR
First Name:JARED
Middle Name:S
Last Name:CASS
Suffix:
Gender:M
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:7326 STATE ROUTE 19 UNIT 2207
Mailing Address - Street 2:
Mailing Address - City:MOUNT GILEAD
Mailing Address - State:OH
Mailing Address - Zip Code:43338-9330
Mailing Address - Country:US
Mailing Address - Phone:419-946-5488
Mailing Address - Fax:
Practice Address - Street 1:1750 WEST FOURTH STREET
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44906
Practice Address - Country:US
Practice Address - Phone:419-526-8342
Practice Address - Fax:419-526-8151
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT.004216225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist