Provider Demographics
NPI:1154984557
Name:D'ORNELLAS, KASSIDY
Entity type:Individual
Prefix:
First Name:KASSIDY
Middle Name:
Last Name:D'ORNELLAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KASSIDY
Other - Middle Name:
Other - Last Name:HITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7500 SAN FELIPE ST STE 990
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-1708
Mailing Address - Country:US
Mailing Address - Phone:713-706-6176
Mailing Address - Fax:
Practice Address - Street 1:29228 US 19 N
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33761-2101
Practice Address - Country:US
Practice Address - Phone:727-351-4191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-21
Last Update Date:2022-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician