Provider Demographics
NPI:1245028059
Name:FISHER, CASSANDRA MICHEALE
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:MICHEALE
Last Name:FISHER
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:CASSANDRA
Other - Middle Name:MICHEALE
Other - Last Name:ROBINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7108 S KANNER HWY
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34997-7462
Mailing Address - Country:US
Mailing Address - Phone:855-832-6727
Mailing Address - Fax:
Practice Address - Street 1:134 NE 1291
Practice Address - Street 2:
Practice Address - City:KNOB NOSTER
Practice Address - State:MO
Practice Address - Zip Code:65336-2360
Practice Address - Country:US
Practice Address - Phone:660-383-3638
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-30
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst