Provider Demographics
NPI:1033230115
Name:MASON, DANA C (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:C
Last Name:MASON
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6310 RED HAVEN RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-4475
Mailing Address - Country:US
Mailing Address - Phone:410-381-5154
Mailing Address - Fax:
Practice Address - Street 1:9650 SANTIAGO RD STE 9
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-3960
Practice Address - Country:US
Practice Address - Phone:443-283-0618
Practice Address - Fax:443-283-0347
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03121235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist