Provider Demographics
NPI:1780088591
Name:FRITZ, CASSIE RENA (COTA/L)
Entity type:Individual
Prefix:MRS
First Name:CASSIE
Middle Name:RENA
Last Name:FRITZ
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:CASSIE
Other - Middle Name:RENA
Other - Last Name:LOWANS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:COTA/L
Mailing Address - Street 1:12700 FORT LOUDON RD
Mailing Address - Street 2:
Mailing Address - City:MERCERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17236-9790
Mailing Address - Country:US
Mailing Address - Phone:717-816-4761
Mailing Address - Fax:
Practice Address - Street 1:801 N HANOVER ST
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17013-1599
Practice Address - Country:US
Practice Address - Phone:717-249-5322
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-22
Last Update Date:2014-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOP006029224Z00000X
MDA01538224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant