Provider Demographics
NPI:1912247420
Name:BASEHEART, CASANDRA DENISE (SLP)
Entity Type:Individual
Prefix:MRS
First Name:CASANDRA
Middle Name:DENISE
Last Name:BASEHEART
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:835 WAKEFIELD ST
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42103-1554
Mailing Address - Country:US
Mailing Address - Phone:502-827-3200
Mailing Address - Fax:
Practice Address - Street 1:835 WAKEFIELD ST
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42103-1554
Practice Address - Country:US
Practice Address - Phone:502-827-3200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-20
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY142439235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist