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General NPI Number Information
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NPI Number | 1497414734
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Entity Type | Individual
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Provider Name | CASSIE LYNNE HART
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Gender | Female
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Dates
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Enumeration Date | 12/14/2021
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Last Update Date | 12/14/2021
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Provider Practice Location Address
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Address Line | 900 ORCHID AVE
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City | KEYSTONE HEIGHTS
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State | FL
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Zip | 32656-6508
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Country | US
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Telephone | 352-473-2761
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Fax |
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Provider Business Mailing Address
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Address Line | 7702 NW 290TH AVE
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City | ALACHUA
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State | FL
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Zip | 32615-3372
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Country | US
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Telephone | 352-681-8393
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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