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NPI 1104704147

NPI 1104704147 : CASSANDRA MAE VIETAS-PRETE DPT : GAHANNA, OH

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General NPI Number Information
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    NPI Number           |    1104704147
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    Entity Type          |    Individual 
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    Provider Name        |    CASSANDRA MAE VIETAS-PRETE DPT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    08/26/2025
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    Last Update Date     |    08/26/2025
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Provider Practice Location Address
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    Address Line         |    920 N HAMILTON RD STE 400 
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    City                 |    GAHANNA
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    State                |    OH
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    Zip                  |    43230-1757
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    Country              |    US
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    Telephone            |    210-677-9570
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    803 LINDENHAVEN RD 
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    City                 |    GAHANNA
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    State                |    OH
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    Zip                  |    43230-2079
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    Country              |    US
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    Telephone            |    210-677-9570
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    225100000X
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    Taxonomy Name        |    Physical Therapist
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    License Number       |    019182
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    License Number State |    OH
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