MEDICARE: MICHELLE CASSIDY M.ED., RBT

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-21-185576	AZ

General Provider Information

NPI Number	:	1851254106
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE CASSIDY M.ED., RBT

Provider Business Mailing Address
First Line	:	18521 E QUEEN CREEK RD STE 105-627
Second Line	:
City	:	QUEEN CREEK
State	:	AZ
Zip	:	85142-5866
Country	:	US
Telephone Number	:	480-361-1025
Fax Number	:	480-814-7488

Provider Business Practice Location Address
First Line	:	18521 E QUEEN CREEK RD STE 105-627
Second Line	:
City	:	QUEEN CREEK
State	:	AZ
Zip	:	85142-5866
Country	:	US
Telephone Number	:	480-361-1025
Fax Number	:	480-814-7488

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

Provider Enumeration Date	:	12/04/2025
Last Update Date	:	12/04/2025

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