Provider Demographics
NPI:1174831416
Name:SCHUH, CASSANDRA LEE (OTR)
Entity Type:Individual
Prefix:MRS
First Name:CASSANDRA
Middle Name:LEE
Last Name:SCHUH
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:MISS
Other - First Name:CASSANDRA
Other - Middle Name:LEE
Other - Last Name:HOLZMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2323 N CASALOMA DR
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54913-8284
Mailing Address - Country:US
Mailing Address - Phone:920-730-8833
Mailing Address - Fax:920-738-9089
Practice Address - Street 1:2323 N CASALOMA DR
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54913-8284
Practice Address - Country:US
Practice Address - Phone:920-730-8833
Practice Address - Fax:920-738-9089
Is Sole Proprietor?:No
Enumeration Date:2010-09-21
Last Update Date:2014-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4888225X00000X
WI4888-26225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1174831416Medicaid