Basic Information
| Provider Information | |||||||||
| NPI: | 1295248458 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | COMPTON | ||||||||
| FirstName: | CASSANDRA | ||||||||
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| Credential: | OTR/L | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4907 DANIELS RUN RD NE | ||||||||
| Address2: | |||||||||
| City: | PILOT | ||||||||
| State: | VA | ||||||||
| PostalCode: | 241381564 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5406168013 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3615 W MAIN ST | ||||||||
| Address2: | |||||||||
| City: | SALEM | ||||||||
| State: | VA | ||||||||
| PostalCode: | 241531961 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5403804500 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/09/2017 | ||||||||
| LastUpdateDate: | 08/05/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/05/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225XG0600X | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Gerontology | 225X00000X | 0119006884 | VA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.