Provider Demographics
NPI:1831730712
Name:WINTER, CASSANDRA LEE (OTR/L)
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:LEE
Last Name:WINTER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:CASSANDRA
Other - Middle Name:LEE
Other - Last Name:MARSHALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5427 JOHNSON DR
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:KS
Mailing Address - Zip Code:66205-2912
Mailing Address - Country:US
Mailing Address - Phone:913-912-2174
Mailing Address - Fax:
Practice Address - Street 1:5427 JOHNSON DR
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:KS
Practice Address - Zip Code:66205-2912
Practice Address - Country:US
Practice Address - Phone:913-912-2174
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-02
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1704143225XP0200X
MO2019037068225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics