Provider Demographics
NPI:1477139376
Name:CLARIETT, CASSANDRA DENISE
Entity Type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:DENISE
Last Name:CLARIETT
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 1:7976 W STAR CATCHER DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85743-1503
Mailing Address - Country:US
Mailing Address - Phone:901-692-1939
Mailing Address - Fax:
Practice Address - Street 1:7976 W STAR CATCHER DR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85743-1503
Practice Address - Country:US
Practice Address - Phone:901-692-1939
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-22
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
02OtherSELF-PAY