Provider Demographics
NPI:1093527517
Name:RICHARDSON, CASSIE MICHELLE (DSP)
Entity type:Individual
Prefix:
First Name:CASSIE
Middle Name:MICHELLE
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:DSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1484 PRESTON AVE
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44305-4126
Mailing Address - Country:US
Mailing Address - Phone:330-671-9897
Mailing Address - Fax:
Practice Address - Street 1:1484 PRESTON AVE
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44305-4126
Practice Address - Country:US
Practice Address - Phone:330-671-9897
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-22
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst