Provider Demographics
NPI:1891033999
Name:BROWN, CASSIE JO (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:CASSIE
Middle Name:JO
Last Name:BROWN
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 1:717 WINTER PARK
Mailing Address - Street 2:
Mailing Address - City:BLANCHARD
Mailing Address - State:OK
Mailing Address - Zip Code:73010-9823
Mailing Address - Country:US
Mailing Address - Phone:405-795-1522
Mailing Address - Fax:405-485-4690
Practice Address - Street 1:717 WINTER PARK
Practice Address - Street 2:
Practice Address - City:BLANCHARD
Practice Address - State:OK
Practice Address - Zip Code:73010-9823
Practice Address - Country:US
Practice Address - Phone:405-795-1522
Practice Address - Fax:405-485-4690
Is Sole Proprietor?:No
Enumeration Date:2013-01-24
Last Update Date:2013-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1723225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist