Provider Demographics
NPI:1437921418
Name:PRITCHETT, CASSANDRA DIANNE
Entity Type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:DIANNE
Last Name:PRITCHETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3660 S COX AVE APT 2208
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65807-6950
Mailing Address - Country:US
Mailing Address - Phone:573-205-6869
Mailing Address - Fax:
Practice Address - Street 1:252 N CENTER ST
Practice Address - Street 2:
Practice Address - City:FORDLAND
Practice Address - State:MO
Practice Address - Zip Code:65652-9251
Practice Address - Country:US
Practice Address - Phone:417-738-2223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-24
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20220362152355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant