Provider Demographics
NPI:1396224424
Name:MARASCH, CASSANDRA (DPT)
Entity Type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:
Last Name:MARASCH
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:CASSANDRA
Other - Middle Name:
Other - Last Name:MARASCH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:S69W14440 CORNELL DR
Mailing Address - Street 2:
Mailing Address - City:MUSKEGO
Mailing Address - State:WI
Mailing Address - Zip Code:53150-3128
Mailing Address - Country:US
Mailing Address - Phone:262-357-1707
Mailing Address - Fax:
Practice Address - Street 1:945 N 12TH ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53233-1305
Practice Address - Country:US
Practice Address - Phone:414-219-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-09
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI14382-24225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist