Provider Demographics
NPI:1487190872
Name:SEMORE, CASSIE A
Entity Type:Individual
Prefix:
First Name:CASSIE
Middle Name:A
Last Name:SEMORE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CASSIE
Other - Middle Name:
Other - Last Name:CHRISTIAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6449 PRIMM SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:LYLES
Mailing Address - State:TN
Mailing Address - Zip Code:37098-3061
Mailing Address - Country:US
Mailing Address - Phone:931-996-9212
Mailing Address - Fax:
Practice Address - Street 1:6449 PRIMM SPRINGS RD
Practice Address - Street 2:
Practice Address - City:LYLES
Practice Address - State:TN
Practice Address - Zip Code:37098-3061
Practice Address - Country:US
Practice Address - Phone:931-996-9212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-10
Last Update Date:2017-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5673235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist