Provider Demographics
NPI:1275322059
Name:FRIESS, CASSANDRA DAE
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:DAE
Last Name:FRIESS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:CASSIE
Other - Middle Name:DAE
Other - Last Name:FRIESS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:8300 JEFFERSON ST NE STE B
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87113-1734
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3555 SUNSET OFFICE DR STE 101
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63127-1045
Practice Address - Country:US
Practice Address - Phone:314-240-2031
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-06
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician