Provider Demographics
NPI:1659827822
Name:CASSIAS, JERUZALEM ZEUDI
Entity Type:Individual
Prefix:
First Name:JERUZALEM
Middle Name:ZEUDI
Last Name:CASSIAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JERUZALEM
Other - Middle Name:ZEUDI
Other - Last Name:BRANYAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:SLP-ASSISTANT
Mailing Address - Street 1:2160 FOX RIDGE TRL
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-2605
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2160 FOX RIDGE TRL
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-2605
Practice Address - Country:US
Practice Address - Phone:214-755-7504
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-29
Last Update Date:2016-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX357842355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant