Provider Demographics
NPI:1184213175
Name:BEAN, CASSANDRA MICHELLE
Entity Type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:MICHELLE
Last Name:BEAN
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 1:1094 W SWARTZVILLE RD
Mailing Address - Street 2:
Mailing Address - City:REINHOLDS
Mailing Address - State:PA
Mailing Address - Zip Code:17569-9405
Mailing Address - Country:US
Mailing Address - Phone:717-466-8161
Mailing Address - Fax:
Practice Address - Street 1:200 LUTHER LN
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:PA
Practice Address - Zip Code:17512-2401
Practice Address - Country:US
Practice Address - Phone:717-684-0678
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-13
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist