Provider Demographics
NPI:1578075644
Name:JONES, CASSANDRA J
Entity Type:Individual
Prefix:MS
First Name:CASSANDRA
Middle Name:J
Last Name:JONES
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 1:3869 E 140TH ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44128-1003
Mailing Address - Country:US
Mailing Address - Phone:216-785-0922
Mailing Address - Fax:
Practice Address - Street 1:3869 E 140TH ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44128-1003
Practice Address - Country:US
Practice Address - Phone:216-785-0922
Practice Address - Fax:216-785-0922
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-30
Last Update Date:2017-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33.023391225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist