Provider Demographics
NPI:1457839151
Name:HEGWOOD, CASSANDRA J
Entity Type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:J
Last Name:HEGWOOD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CASSANDRA
Other - Middle Name:J
Other - Last Name:MARGRAVE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1003 N ACADEMY ST
Mailing Address - Street 2:
Mailing Address - City:GUYMON
Mailing Address - State:OK
Mailing Address - Zip Code:73942-3536
Mailing Address - Country:US
Mailing Address - Phone:580-461-0369
Mailing Address - Fax:
Practice Address - Street 1:1521 HWY 54 N.
Practice Address - Street 2:
Practice Address - City:GUYMON
Practice Address - State:OK
Practice Address - Zip Code:73942
Practice Address - Country:US
Practice Address - Phone:580-338-5851
Practice Address - Fax:580-338-6022
Is Sole Proprietor?:No
Enumeration Date:2018-08-03
Last Update Date:2018-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker