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NPI Code Detail

MEDICARE: CASSANDRA GORDON OTR/L

MEDICARE: CASSANDRA GORDON OTR/L
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
1225X00000XOccupational TherapistMO
2225X00000XOccupational TherapistIL

General Provider Information

NPI Number : 1871046177
Entity Type Code : Individual
Provider Name (Legal Business Name) : CASSANDRA GORDON OTR/L
Provider Business Mailing Address
First Line : 708 SAINT LOUIS ST
Second Line :
City : EDWARDSVILLE
State : IL
Zip : 62025-1427
Country : US
Telephone Number : 618-656-1182
Fax Number :
Provider Business Practice Location Address
First Line : 708 SAINT LOUIS ST
Second Line :
City : EDWARDSVILLE
State : IL
Zip : 62025-1427
Country : US
Telephone Number : 618-656-1182
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/03/2016
Last Update Date : 11/25/2025

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Directions to “ CASSANDRA GORDON OTR/L” Practice Location

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