Provider Demographics
NPI:1235459322
Name:HITCH, CASSIE (BS)
Entity Type:Individual
Prefix:MS
First Name:CASSIE
Middle Name:
Last Name:HITCH
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7075 INDUSTRIAL RD
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41042-3053
Mailing Address - Country:US
Mailing Address - Phone:859-282-1770
Mailing Address - Fax:859-282-0532
Practice Address - Street 1:7075 INDUSTRIAL RD
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-3053
Practice Address - Country:US
Practice Address - Phone:859-282-1770
Practice Address - Fax:859-282-0532
Is Sole Proprietor?:No
Enumeration Date:2010-06-11
Last Update Date:2010-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY610661458OtherGROUP TAX ID NUMBER