Cassidy Blackburn, DT
Individual provider Active NPI Developmental Therapist · Fort Wayne, IN
NPI 1891445987 · NPPES record last updated Mar 24, 2022
Key facts
- NPI
- 1891445987
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Developmental Therapist 222Q00000X
- Practice address
- 2626 Saint Joe Center Rd
Fort Wayne, IN 46825-5042 - Phone
- (260) 497-0328
- Fax
- (260) 497-0904
- NPI assigned
- Mar 24, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hand in Hand Comprehensive Therapy Specialists Inc | Current |
Accepting new patients |
Locations
2626 Saint Joe Center Rd
Fort Wayne, IN 46825
Phone (260) 497-0328
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmental Therapist | 222Q00000X | Yes |
Addresses
Primary practice location
2626 Saint Joe Center Rd
Fort Wayne, IN 46825-5042
Mailing address
2626 Saint Joe Center Rd
Fort Wayne, IN 46825-5042
Phone (260) 497-0328
Other providers in Fort Wayne, IN
- Anna M Black
- Bryan Black
- Cynthia Black
- Seth Black
- Blackbird Counseling, LLC
- Melissa Jane Blackmer
- Lyndsie Blackmon
- Sailaja M Blackmon
- Toni Walker Blackwood
- Amy Lynn Blaettner
All providers in Fort Wayne, IN · Developmental Therapist in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 24, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.