Provider Demographics
NPI:1235930397
Name:BECKSTEIN, KASSIDY RAE (OTD, OTR)
Entity type:Individual
Prefix:
First Name:KASSIDY
Middle Name:RAE
Last Name:BECKSTEIN
Suffix:
Gender:
Credentials:OTD, OTR
Other - Prefix:
Other - First Name:KASSIDY
Other - Middle Name:RAE
Other - Last Name:GRIFFITH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:9532 PARK MERIDIAN DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-1331
Mailing Address - Country:US
Mailing Address - Phone:260-449-0068
Mailing Address - Fax:
Practice Address - Street 1:13500 N MERIDIAN ST
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-1456
Practice Address - Country:US
Practice Address - Phone:317-582-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-24
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31007721A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist