Provider Demographics
NPI:1235721754
Name:BAUS, CASSIE ANN (OTD, OTR/L)
Entity Type:Individual
Prefix:DR
First Name:CASSIE
Middle Name:ANN
Last Name:BAUS
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:CASSIE
Other - Middle Name:ANN
Other - Last Name:MATTHYS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4777 AVON ST
Mailing Address - Street 2:
Mailing Address - City:SHOREVIEW
Mailing Address - State:MN
Mailing Address - Zip Code:55126-5859
Mailing Address - Country:US
Mailing Address - Phone:906-241-0108
Mailing Address - Fax:
Practice Address - Street 1:480 OSBORNE RD NE STE 280
Practice Address - Street 2:
Practice Address - City:FRIDLEY
Practice Address - State:MN
Practice Address - Zip Code:55432-2866
Practice Address - Country:US
Practice Address - Phone:763-784-3155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-05
Last Update Date:2021-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6913-26225X00000X
MN106422225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist