Provider Demographics
NPI:1710382759
Name:MURRAY, CASSANDRA JUDITH (OTR/L)
Entity Type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:JUDITH
Last Name:MURRAY
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4736 ZANE AVE N
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL
Mailing Address - State:MN
Mailing Address - Zip Code:55429-3532
Mailing Address - Country:US
Mailing Address - Phone:952-544-0349
Mailing Address - Fax:952-545-2099
Practice Address - Street 1:11606 WAYZATA BLVD
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55305
Practice Address - Country:US
Practice Address - Phone:952-544-0349
Practice Address - Fax:952-545-2099
Is Sole Proprietor?:No
Enumeration Date:2014-11-04
Last Update Date:2018-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN104739225XP0200X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics