Provider Demographics
NPI:1891201125
Name:BORTOT, CASSANDRA MARIE (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:MARIE
Last Name:BORTOT
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1405 GRANDVIEW AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15211-1111
Mailing Address - Country:US
Mailing Address - Phone:724-858-6432
Mailing Address - Fax:
Practice Address - Street 1:1100 WASHINGTON AVE STE 317
Practice Address - Street 2:
Practice Address - City:CARNEGIE
Practice Address - State:PA
Practice Address - Zip Code:15106-3617
Practice Address - Country:US
Practice Address - Phone:412-489-5527
Practice Address - Fax:412-489-5726
Is Sole Proprietor?:No
Enumeration Date:2017-12-22
Last Update Date:2017-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL013805235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist