Provider Demographics
NPI:1659189587
Name:LOREE, CASSIDY MACHAEL (OTA)
Entity type:Individual
Prefix:
First Name:CASSIDY
Middle Name:MACHAEL
Last Name:LOREE
Suffix:
Gender:F
Credentials:OTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 EVANS GLADE
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:GA
Mailing Address - Zip Code:30143-5264
Mailing Address - Country:US
Mailing Address - Phone:706-273-6411
Mailing Address - Fax:
Practice Address - Street 1:4400 E US 64 ALT
Practice Address - Street 2:
Practice Address - City:MURPHY
Practice Address - State:NC
Practice Address - Zip Code:28906-4751
Practice Address - Country:US
Practice Address - Phone:828-516-1750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-23
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC17373224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant