Provider Demographics
NPI:1255954657
Name:CONDON, KASSANDRA (AUD)
Entity type:Individual
Prefix:DR
First Name:KASSANDRA
Middle Name:
Last Name:CONDON
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:KASSANDRA
Other - Middle Name:
Other - Last Name:URENA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:198 MASSACHUSETTS AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:NORTH ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01845-4143
Mailing Address - Country:US
Mailing Address - Phone:978-685-7550
Mailing Address - Fax:
Practice Address - Street 1:198 MASSACHUSETTS AVE STE 103
Practice Address - Street 2:
Practice Address - City:NORTH ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845-4143
Practice Address - Country:US
Practice Address - Phone:978-685-7550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-20
Last Update Date:2020-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4812-SP-AU231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist