Provider Demographics
NPI:1760997365
Name:HARDESTER, CASSANDRA (EDD, LAT, ATC)
Entity Type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:
Last Name:HARDESTER
Suffix:
Gender:F
Credentials:EDD, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 E MARY ST
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502-4721
Mailing Address - Country:US
Mailing Address - Phone:301-697-6798
Mailing Address - Fax:
Practice Address - Street 1:1010 WAYNE AVE STE 410
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-5655
Practice Address - Country:US
Practice Address - Phone:240-600-0177
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-06
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA00004662255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer