Basic Information
Provider Information
NPI: 1386163061
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HOOPER
FirstName: CASSIE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 659 S SALISBURY BLVD STE 1B
Address2:  
City: SALISBURY
State: MD
PostalCode: 218015458
CountryCode: US
TelephoneNumber: 4108313226
FaxNumber:  
Practice Location
Address1: 598 CYNWOOD DR STE 101
Address2:  
City: EASTON
State: MD
PostalCode: 216013875
CountryCode: US
TelephoneNumber: 4107709720
FaxNumber: 4107709725
Other Information
ProviderEnumerationDate: 09/14/2017
LastUpdateDate: 10/02/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X26784MDN Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 
225100000XJT-0000949DEY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


Home