Provider Demographics
NPI:1497426464
Name:MCKNIGHT, CASSANDRA LEIGH (MSOTR/L)
Entity Type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:LEIGH
Last Name:MCKNIGHT
Suffix:
Gender:F
Credentials:MSOTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:872 COUNTY ROUTE 44
Mailing Address - Street 2:
Mailing Address - City:CHASE MILLS
Mailing Address - State:NY
Mailing Address - Zip Code:13621-3174
Mailing Address - Country:US
Mailing Address - Phone:315-323-1871
Mailing Address - Fax:
Practice Address - Street 1:84 NIGHTENGALE AVE
Practice Address - Street 2:
Practice Address - City:MASSENA
Practice Address - State:NY
Practice Address - Zip Code:13662-2538
Practice Address - Country:US
Practice Address - Phone:315-764-3700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-21
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024259225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist