Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 1-16-23708 |
NPI | 1003325572 |
---|---|
Provider Name | Cassandra Paige Kassel |
First Address | Stamford, CT 06905-1210 |
Second Address | Stamford, CT 06905 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2017 |
Last Update Date | 27/09/2017 |