Provider Demographics
NPI:1437010600
Name:DEARDORF-SNOW, CASSEY
Entity type:Individual
Prefix:
First Name:CASSEY
Middle Name:
Last Name:DEARDORF-SNOW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 GREEN ST
Mailing Address - Street 2:
Mailing Address - City:VIDALIA
Mailing Address - State:GA
Mailing Address - Zip Code:30474-5142
Mailing Address - Country:US
Mailing Address - Phone:912-585-3342
Mailing Address - Fax:
Practice Address - Street 1:510 GREEN ST
Practice Address - Street 2:
Practice Address - City:VIDALIA
Practice Address - State:GA
Practice Address - Zip Code:30474-5142
Practice Address - Country:US
Practice Address - Phone:912-585-3342
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-18
Last Update Date:2025-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst