Provider Demographics
NPI:1699551630
Name:PASTORELLI, CASSANDRA (OTR/L)
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:
Last Name:PASTORELLI
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 PLUMMER LN
Mailing Address - Street 2:
Mailing Address - City:KENNEBUNK
Mailing Address - State:ME
Mailing Address - Zip Code:04043-6624
Mailing Address - Country:US
Mailing Address - Phone:207-468-1086
Mailing Address - Fax:
Practice Address - Street 1:71 PINELAND DR
Practice Address - Street 2:
Practice Address - City:NEW GLOUCESTER
Practice Address - State:ME
Practice Address - Zip Code:04260-5127
Practice Address - Country:US
Practice Address - Phone:207-468-1086
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-06
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOT4501225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist