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General NPI Number Information
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NPI Number | 1629854484
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Entity Type | Individual
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Provider Name | CASSIDY METCHEAR OTR/L
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Gender | Female
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Dates
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Enumeration Date | 09/06/2023
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Last Update Date | 09/06/2023
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Provider Practice Location Address
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Address Line | 4902 CREEKSIDE DR STE A
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City | CLEARWATER
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State | FL
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Zip | 33760-4033
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Country | US
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Telephone | 727-592-9100
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Fax |
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Provider Business Mailing Address
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Address Line | 3135 66TH ST SW
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City | NAPLES
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State | FL
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Zip | 34105-7319
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Country | US
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Telephone | 239-537-3034
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 22031
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License Number State | FL
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