Provider Demographics
NPI:1225114382
Name:MCFADDEN, CASSANDRA LEIGH (ATC)
Entity Type:Individual
Prefix:MS
First Name:CASSANDRA
Middle Name:LEIGH
Last Name:MCFADDEN
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 EAST AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNT CARMEL
Mailing Address - State:PA
Mailing Address - Zip Code:17851-1412
Mailing Address - Country:US
Mailing Address - Phone:570-339-5588
Mailing Address - Fax:
Practice Address - Street 1:MOORE AVENUE
Practice Address - Street 2:KLARC
Practice Address - City:LEWISBURG
Practice Address - State:PA
Practice Address - Zip Code:17837
Practice Address - Country:US
Practice Address - Phone:570-577-3065
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART0039912255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer