Provider Demographics
NPI:1952062564
Name:PHILIPP, CASANDRA
Entity Type:Individual
Prefix:
First Name:CASANDRA
Middle Name:
Last Name:PHILIPP
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 8TH AVE S APT 470
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37204-2478
Mailing Address - Country:US
Mailing Address - Phone:678-315-3587
Mailing Address - Fax:
Practice Address - Street 1:805 S CHURCH ST STE 7
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37130-4916
Practice Address - Country:US
Practice Address - Phone:615-962-8345
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-05
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6591235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist