Provider Demographics
NPI:1184474256
Name:HARDER, CASSIA R
Entity type:Individual
Prefix:
First Name:CASSIA
Middle Name:R
Last Name:HARDER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2010 E HENNEPIN AVE STE 45
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55413-2706
Mailing Address - Country:US
Mailing Address - Phone:612-405-9660
Mailing Address - Fax:
Practice Address - Street 1:2010 E HENNEPIN AVE STE 45
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55413-2706
Practice Address - Country:US
Practice Address - Phone:612-405-9660
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLIC412061225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist