Provider Demographics
NPI:1790431856
Name:DISHMAN, CASSANDRA T (LMT)
Entity Type:Individual
Prefix:MRS
First Name:CASSANDRA
Middle Name:T
Last Name:DISHMAN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6921 SACRED CIR
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89436-5470
Mailing Address - Country:US
Mailing Address - Phone:720-448-1440
Mailing Address - Fax:
Practice Address - Street 1:1351 CORPORATE BLVD
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-7102
Practice Address - Country:US
Practice Address - Phone:775-829-7774
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-28
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV10779225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist