Provider Demographics
NPI:1144584335
Name:PAVLOVIC, CASSIE LYNN (MS)
Entity Type:Individual
Prefix:MS
First Name:CASSIE
Middle Name:LYNN
Last Name:PAVLOVIC
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1715 E GIRARD PL APT 1015
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-9230
Mailing Address - Country:US
Mailing Address - Phone:217-440-7622
Mailing Address - Fax:
Practice Address - Street 1:975 PLATTE RIVER BLVD
Practice Address - Street 2:UNIT O
Practice Address - City:BRIGHTON
Practice Address - State:CO
Practice Address - Zip Code:80601-4349
Practice Address - Country:US
Practice Address - Phone:303-659-8822
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-02
Last Update Date:2012-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.010166235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist