Provider Demographics
NPI:1356595078
Name:SASSANO, KERRI LYNNE (MS, CCC-SLP/L)
Entity type:Individual
Prefix:MRS
First Name:KERRI
Middle Name:LYNNE
Last Name:SASSANO
Suffix:
Gender:F
Credentials:MS, CCC-SLP/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 PLATEAU ST
Mailing Address - Street 2:ALTOONA
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16602-6816
Mailing Address - Country:US
Mailing Address - Phone:814-931-1210
Mailing Address - Fax:
Practice Address - Street 1:711 PLATEAU ST
Practice Address - Street 2:ALTOONA
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16602-6816
Practice Address - Country:US
Practice Address - Phone:814-931-1210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-07
Last Update Date:2008-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL007191235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist