Doctor Name: | CASSANDRA LEE ABBOTT |
NPI Number: | 1134358179 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PCC-S |
License Number: | E0008183 |
Business Practice Address: | 202 E Bagley Rd Berea, OH - 440172058 |
Business Phone Number: | 4402608528 |
Business Fax Number: | 4402608544 |
Mailing Address: | 202 E Bagley Rd, BEREA |
State: | OH |
Postal Code: | 440172058 |
Phone Number: | 4402608528 |
Fax Number: | 4402608544 |
NPI Enumeration Date: | 07/13/2009 |
NPI Last Update Date: | 07/13/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | E0008183 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |