Healthcare Provider Details

I. General information

NPI: 1083307276
Provider Name (Legal Business Name): KASSIDY N OVERFIELD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2023
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

521 W NEW YORK AVE STE A
DELAND FL
32720-5350
US

IV. Provider business mailing address

46 VOLUSIA DR
DEBARY FL
32713-3231
US

V. Phone/Fax

Practice location:
  • Phone: 386-244-9519
  • Fax:
Mailing address:
  • Phone: 352-801-2976
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: