MEDICARE: MRS. CASSANDRA POOLE SLP

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
1	235Z00000X	Speech-Language Pathologist	10795	NC

General Provider Information

NPI Number	:	1164754438
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CASSANDRA POOLE SLP

Provider Business Mailing Address
First Line	:	PO BOX 831
Second Line	:
City	:	MADILL
State	:	OK
Zip	:	73446-0831
Country	:	US
Telephone Number	:	866-795-3301
Fax Number	:	580-795-7307

Provider Business Practice Location Address
First Line	:	924 MAIN ST STE 350
Second Line	:
City	:	NORTH WILKESBORO
State	:	NC
Zip	:	28659-4282
Country	:	US
Telephone Number	:	336-566-6104
Fax Number	:	336-990-9242

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/11/2010
Last Update Date	:	03/13/2026

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