Provider Demographics
NPI:1750973665
Name:GARVER, CASSANDRA (HIS)
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:
Last Name:GARVER
Suffix:
Gender:F
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:936 PLYMOUTH DR
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57703-9033
Mailing Address - Country:US
Mailing Address - Phone:605-593-2220
Mailing Address - Fax:
Practice Address - Street 1:2001 7TH ST STE 201
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-4661
Practice Address - Country:US
Practice Address - Phone:605-342-1619
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-11
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD427H237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist