MEDICARE: DR. CASSANDRA M. GERMAIN PHD

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	103TA0700X	Adult Development & Aging Psychologist
2	103TB0200X	Cognitive & Behavioral Psychologist

General Provider Information

NPI Number	:	1659691293
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CASSANDRA M. GERMAIN PHD

Provider Business Mailing Address
First Line	:	1228 LINKS DR
Second Line	:
City	:	MORRISVILLE
State	:	NC
Zip	:	27560-7056
Country	:	US
Telephone Number	:	919-649-4650
Fax Number	:

Provider Business Practice Location Address
First Line	:	1228 LINKS DR
Second Line	:
City	:	MORRISVILLE
State	:	NC
Zip	:	27560-7056
Country	:	US
Telephone Number	:	919-649-4650
Fax Number	:

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

Provider Enumeration Date	:	06/06/2010
Last Update Date	:	01/04/2011

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