Cassandra Bollinger

Individual provider Active NPI Speech-Language Pathologist · Jackson, MO

NPI 1083087019 · NPPES record last updated Nov 13, 2015

Key facts

NPI
1083087019
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
2015035637 (MO)
Practice address
614 E Adams St
Jackson, MO 63755-2150
Phone
(573) 243-9501
NPI assigned
Nov 13, 2015
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2015035637MOMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson R-2 Schools Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 2015035637 MO Yes

Addresses

Primary practice location

614 E Adams St
Jackson, MO 63755-2150

Mailing address

614 E Adams St
Jackson, MO 63755-2150
Phone (573) 243-9501

Other providers in Jackson, MO

All providers in Jackson, MO · Speech-Language Pathologist in Missouri

Sources for this page

Verify at the official NPI Registry.