Provider Demographics
NPI:1932615531
Name:SASSE, DANA (CCC-SLP)
Entity Type:Individual
Prefix:MR
First Name:DANA
Middle Name:
Last Name:SASSE
Suffix:
Gender:M
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 1:614 S LEE ST
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-3820
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:INGLESIDE OF ROCK CREEK
Practice Address - Street 2:3050 MILITARY RD. NW
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:22314-2231
Practice Address - Country:US
Practice Address - Phone:860-463-3716
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-18
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCSLP001484235Z00000X
VA2202008513235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist