Healthcare Provider Details

I. General information

NPI: 1215152616
Provider Name (Legal Business Name): MOLLY CASSADY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 ALBERT SABIN WAY
CINCINNATI OH
45229-2801
US

IV. Provider business mailing address

3435 TRASKWOOD CIR APT A
CINCINNATI OH
45208-1851
US

V. Phone/Fax

Practice location:
  • Phone: 513-558-5801
  • Fax:
Mailing address:
  • Phone: 513-558-5801
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Registered Nurse
License NumberRN131742
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: