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General NPI Number Information
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NPI Number | 1710332176
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Entity Type | Individual
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Provider Name | CASSANDRA DYKIN
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Gender | Female
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Dates
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Enumeration Date | 05/04/2016
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Last Update Date | 05/04/2016
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Provider Practice Location Address
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Address Line | 2181 AMBLESIDE DR
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City | CLEVELAND
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State | OH
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Zip | 44106-4645
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Country | US
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Telephone | 216-791-2968
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Fax |
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Provider Business Mailing Address
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Address Line | 10157 INDEPENDENCE DR
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City | NORTH ROYALTON
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State | OH
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Zip | 44133-3404
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Country | US
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Telephone | 440-638-9266
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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 | 246Z00000X
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Taxonomy Name | Other Specialist/Technologist
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License Number | PTA.10429
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License Number State | OH
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