Provider Demographics
NPI:1346054368
Name:YOUNG, CASSIDY DAWN (OTD, OTR/L)
Entity type:Individual
Prefix:
First Name:CASSIDY
Middle Name:DAWN
Last Name:YOUNG
Suffix:
Gender:
Credentials:OTD, OTR/L
Other - Prefix:DR
Other - First Name:CASSIDY
Other - Middle Name:DAWN
Other - Last Name:YOUNG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OTD, OTR/L
Mailing Address - Street 1:6319 E BECKETT TRL
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:86314-0043
Mailing Address - Country:US
Mailing Address - Phone:602-308-9454
Mailing Address - Fax:
Practice Address - Street 1:3700 N WINDSONG DR
Practice Address - Street 2:
Practice Address - City:PRESCOTT VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:86314-1253
Practice Address - Country:US
Practice Address - Phone:928-759-8800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-03
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZOTH-009678225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist