Provider Demographics
NPI:1184818098
Name:CASSEL, TRICIA DIANE (MS)
Entity Type:Individual
Prefix:MRS
First Name:TRICIA
Middle Name:DIANE
Last Name:CASSEL
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5915 PONCE DE LEON BLVD
Mailing Address - Street 2:SUITE 49
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33146-2435
Mailing Address - Country:US
Mailing Address - Phone:305-668-0355
Mailing Address - Fax:305-668-5344
Practice Address - Street 1:5915 PONCE DE LEON BLVD
Practice Address - Street 2:SUITE 49
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-2435
Practice Address - Country:US
Practice Address - Phone:305-668-0355
Practice Address - Fax:305-668-5344
Is Sole Proprietor?:No
Enumeration Date:2007-09-04
Last Update Date:2010-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY8032103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical