Provider Demographics
NPI:1548214760
Name:CASSIDY, THERESA BILLMEYER (OTD, OTR)
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:BILLMEYER
Last Name:CASSIDY
Suffix:
Gender:F
Credentials:OTD, OTR
Other - Prefix:
Other - First Name:THERESA
Other - Middle Name:CASSIDY
Other - Last Name:BILLMEYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2924 BEACON ST STE D
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-6195
Mailing Address - Country:US
Mailing Address - Phone:719-231-6657
Mailing Address - Fax:
Practice Address - Street 1:2924 BEACON ST STE D
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-6195
Practice Address - Country:US
Practice Address - Phone:719-231-6657
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0000804225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist