Provider Demographics
NPI:1467848457
Name:CASSELLS, MARIA QUEVEDO (OTR)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:QUEVEDO
Last Name:CASSELLS
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6060 BANDOLERO DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-1948
Mailing Address - Country:US
Mailing Address - Phone:915-833-8518
Mailing Address - Fax:
Practice Address - Street 1:6060 BANDOLERO DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-1948
Practice Address - Country:US
Practice Address - Phone:915-833-8518
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-07
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX111369225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist