Provider Demographics
NPI:1932839024
Name:SANTIAGO, CASSANDRA EVE (CTRS)
Entity Type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:EVE
Last Name:SANTIAGO
Suffix:
Gender:F
Credentials:CTRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42595 311TH ST
Mailing Address - Street 2:
Mailing Address - City:TABOR
Mailing Address - State:SD
Mailing Address - Zip Code:57063-6514
Mailing Address - Country:US
Mailing Address - Phone:718-873-5856
Mailing Address - Fax:
Practice Address - Street 1:42595 311TH ST
Practice Address - Street 2:
Practice Address - City:TABOR
Practice Address - State:SD
Practice Address - Zip Code:57063-6514
Practice Address - Country:US
Practice Address - Phone:718-873-5856
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-13
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation TherapistGroup - Single Specialty