Provider Demographics
NPI:1568032779
Name:POOLE, CASSANDRA RENEE (MS CF-SLP)
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:RENEE
Last Name:POOLE
Suffix:
Gender:F
Credentials:MS CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3026 FULWILER RD
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79603-7724
Mailing Address - Country:US
Mailing Address - Phone:909-684-9863
Mailing Address - Fax:
Practice Address - Street 1:3026 FULWILER RD
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79603-7724
Practice Address - Country:US
Practice Address - Phone:909-684-9863
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-29
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist