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NPI Code Detail

MEDICARE: CASSANDRA MUCKLO PEREZ

MEDICARE: CASSANDRA MUCKLO PEREZ
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician9371-08-4393IN

General Provider Information

NPI Number : 1124966650
Entity Type Code : Individual
Provider Name (Legal Business Name) : CASSANDRA MUCKLO PEREZ
Provider Business Mailing Address
First Line : 1421 WATERBURY RD APT 12
Second Line :
City : LAKEWOOD
State : OH
Zip : 44107-4849
Country : US
Telephone Number : 330-550-7521
Fax Number :
Provider Business Practice Location Address
First Line : 18810 HARVARD AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44122-6848
Country : US
Telephone Number : 330-550-7521
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/24/2026
Last Update Date : 03/24/2026

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Directions to “ CASSANDRA MUCKLO PEREZ ” Practice Location

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