Provider Demographics
NPI:1255780391
Name:PAINE, CASSANDRA MARIE (MS, OTR/L)
Entity type:Individual
Prefix:MRS
First Name:CASSANDRA
Middle Name:MARIE
Last Name:PAINE
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:CASSANDRA
Other - Middle Name:MARIE
Other - Last Name:HARRINGTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:64 HARRIS AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04103
Mailing Address - Country:US
Mailing Address - Phone:802-681-8709
Mailing Address - Fax:
Practice Address - Street 1:85 MIDDLE RD.
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:ME
Practice Address - Zip Code:04021
Practice Address - Country:US
Practice Address - Phone:207-829-8007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-09
Last Update Date:2019-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT072.0116527225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist