MEDICARE: CASSIE LYNN CANTLER

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	106S00000X	Behavior Technician	RBT-22-199628	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1538810908
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CASSIE LYNN CANTLER

Provider Business Mailing Address
First Line	:	8219 FRONT BEACH RD STE B #2148
Second Line	:
City	:	PANAMA CITY
State	:	FL
Zip	:	32407-4822
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8219 FRONT BEACH RD STE B
Second Line	:
City	:	PANAMA CITY
State	:	FL
Zip	:	32407-4822
Country	:	US
Telephone Number	:	386-299-1205
Fax Number	:

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

Provider Enumeration Date	:	01/17/2022
Last Update Date	:	01/06/2025

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Directions to “ CASSIE LYNN CANTLER ” Practice Location

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