Provider Demographics
NPI:1306461371
Name:KINNEY, CASSANDRA (AUD)
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:
Last Name:KINNEY
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:CASSANDRA
Other - Middle Name:
Other - Last Name:DILLARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12065 OLD MERIDIAN ST STE 205
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-8777
Mailing Address - Country:US
Mailing Address - Phone:317-705-2700
Mailing Address - Fax:
Practice Address - Street 1:9604 COLDWATER RD STE 103
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46825-2096
Practice Address - Country:US
Practice Address - Phone:765-686-9588
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-15
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter