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General NPI Number Information
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NPI Number | 1811449762
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Entity Type | Individual
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Provider Name | CASSANDRA RENEE CARRASCO
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Gender | Female
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Dates
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Enumeration Date | 10/26/2016
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Last Update Date | 05/09/2023
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Provider Practice Location Address
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Address Line | 14207 HIGGINS RD.
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City | SAN ANTONIO
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State | TX
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Zip | 78217
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Country | US
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Telephone | 575-635-5068
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Fax | 575-826-7887
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Provider Business Mailing Address
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Address Line | 14207 HIGGINS RD.
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City | SAN ANTONIO
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State | TX
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Zip | 78217
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Country | US
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Telephone | 575-635-5068
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Fax | 575-826-7887
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 119838
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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