Provider Demographics
NPI:1750846390
Name:CALDWELL, CASSIE MARIE (MS CF-SLP)
Entity Type:Individual
Prefix:
First Name:CASSIE
Middle Name:MARIE
Last Name:CALDWELL
Suffix:
Gender:F
Credentials:MS CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:702 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:PA
Mailing Address - Zip Code:18704-5845
Mailing Address - Country:US
Mailing Address - Phone:570-283-5848
Mailing Address - Fax:
Practice Address - Street 1:702 3RD AVE
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:PA
Practice Address - Zip Code:18704-5845
Practice Address - Country:US
Practice Address - Phone:570-283-5848
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-07
Last Update Date:2019-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPSL000488235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist