Provider Demographics
NPI:1134390412
Name:SCHANZENBACH, CASSANDRA E (MS, OTR/L)
Entity type:Individual
Prefix:MRS
First Name:CASSANDRA
Middle Name:E
Last Name:SCHANZENBACH
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 6TH AVE W
Mailing Address - Street 2:
Mailing Address - City:WEST FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58078-1720
Mailing Address - Country:US
Mailing Address - Phone:701-356-2100
Mailing Address - Fax:
Practice Address - Street 1:117 6TH AVE W
Practice Address - Street 2:
Practice Address - City:WEST FARGO
Practice Address - State:ND
Practice Address - Zip Code:58078-1720
Practice Address - Country:US
Practice Address - Phone:701-356-2100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-14
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND803225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND52492Medicaid