Provider Demographics
NPI:1740172675
Name:WEBB, CASSIDY
Entity type:Individual
Prefix:
First Name:CASSIDY
Middle Name:
Last Name:WEBB
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:349 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:WORTHINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:41183-9440
Mailing Address - Country:US
Mailing Address - Phone:606-371-8226
Mailing Address - Fax:
Practice Address - Street 1:361 WINDBURN LN
Practice Address - Street 2:
Practice Address - City:GRAYSON
Practice Address - State:KY
Practice Address - Zip Code:41143-8372
Practice Address - Country:US
Practice Address - Phone:606-922-2572
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-16
Last Update Date:2025-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist