Provider Demographics
NPI:1215776570
Name:WURTZBURGER, CASSIDY JADE (MS PSYCH)
Entity type:Individual
Prefix:MRS
First Name:CASSIDY
Middle Name:JADE
Last Name:WURTZBURGER
Suffix:
Gender:F
Credentials:MS PSYCH
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:113 N CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:SEYMOUR
Mailing Address - State:IN
Mailing Address - Zip Code:47274-2176
Mailing Address - Country:US
Mailing Address - Phone:812-515-3160
Mailing Address - Fax:
Practice Address - Street 1:113 N CHESTNUT ST
Practice Address - Street 2:SUITE 301
Practice Address - City:SEYMOUR
Practice Address - State:IN
Practice Address - Zip Code:47274-2197
Practice Address - Country:US
Practice Address - Phone:812-515-3160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-24
Last Update Date:2024-05-24
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health