Provider Demographics
NPI:1295248458
Name:COMPTON, CASSANDRA (OTR/L)
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:
Last Name:COMPTON
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4907 DANIELS RUN RD NE
Mailing Address - Street 2:
Mailing Address - City:PILOT
Mailing Address - State:VA
Mailing Address - Zip Code:24138-1564
Mailing Address - Country:US
Mailing Address - Phone:540-616-8013
Mailing Address - Fax:
Practice Address - Street 1:3615 W MAIN ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:VA
Practice Address - Zip Code:24153-1961
Practice Address - Country:US
Practice Address - Phone:540-380-4500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-09
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225XG0600X
VA0119006884225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XG0600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGerontology