Provider Demographics
NPI:1669854329
Name:CARTEE, CASSIDY LANE
Entity type:Individual
Prefix:
First Name:CASSIDY
Middle Name:LANE
Last Name:CARTEE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CASSIDY
Other - Middle Name:
Other - Last Name:WHITENER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:444 W MADISON ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65806-2939
Mailing Address - Country:US
Mailing Address - Phone:573-330-8790
Mailing Address - Fax:
Practice Address - Street 1:1700 S CAMPBELL AVE STE E
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65807-2000
Practice Address - Country:US
Practice Address - Phone:417-839-4318
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-18
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015018647235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist