Provider Demographics
NPI:1699447623
Name:TOMPKINSON, CASSANDRA ANN (CCC-SLP)
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:ANN
Last Name:TOMPKINSON
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 SUSANNA LN
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10312-1345
Mailing Address - Country:US
Mailing Address - Phone:347-993-4349
Mailing Address - Fax:
Practice Address - Street 1:1171 65TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219-5634
Practice Address - Country:US
Practice Address - Phone:718-236-3394
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-28
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist