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General NPI Number Information
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NPI Number | 1497461396
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Entity Type | Individual
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Provider Name | CASSIDY SCHOMBURG
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Gender | Female
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Dates
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Enumeration Date | 01/25/2023
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Last Update Date | 11/25/2025
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Provider Practice Location Address
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Address Line | 5963 KENTSHIRE DR
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City | KETTERING
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State | OH
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Zip | 45440-4253
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Country | US
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Telephone | 937-952-6379
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Fax |
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Provider Business Mailing Address
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Address Line | 2733 E 12TH ST STE C2
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City | BROOKLYN
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State | NY
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Zip | 11235-4672
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Country | US
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Telephone | 248-846-8700
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Fax | 248-846-8703
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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