Provider Demographics
NPI:1518458058
Name:ZEESE, DINA RUTH
Entity Type:Individual
Prefix:
First Name:DINA
Middle Name:RUTH
Last Name:ZEESE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:890 N LEXINGTON ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22205-1331
Mailing Address - Country:US
Mailing Address - Phone:703-243-1099
Mailing Address - Fax:
Practice Address - Street 1:625 S WAKEFIELD ST
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22204-1480
Practice Address - Country:US
Practice Address - Phone:703-228-5838
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-21
Last Update Date:2018-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2203000637235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist