Provider Demographics
NPI:1508198185
Name:HOUSE, CASSIE NICOLE (MOTR/L)
Entity Type:Individual
Prefix:
First Name:CASSIE
Middle Name:NICOLE
Last Name:HOUSE
Suffix:
Gender:F
Credentials:MOTR/L
Other - Prefix:
Other - First Name:CASSIE
Other - Middle Name:NICOLE
Other - Last Name:SILVEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MOTR/L
Mailing Address - Street 1:PO BOX 354
Mailing Address - Street 2:
Mailing Address - City:BOISE CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73933-0354
Mailing Address - Country:US
Mailing Address - Phone:580-519-1001
Mailing Address - Fax:
Practice Address - Street 1:419 HARDING ST
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:NM
Practice Address - Zip Code:88415-3323
Practice Address - Country:US
Practice Address - Phone:575-374-2353
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-05
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1435225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist