MEDICARE: MR. DANA SASSE CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	SLP001484	DC
2	235Z00000X	Speech-Language Pathologist	2202008513	VA

General Provider Information

NPI Number	:	1932615531
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DANA SASSE CCC-SLP

Provider Business Mailing Address
First Line	:	614 S LEE ST
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22314-3820
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	INGLESIDE OF ROCK CREEK
Second Line	:	3050 MILITARY RD. NW
City	:	WASHINGTON
State	:	DC
Zip	:	22314-2231
Country	:	US
Telephone Number	:	860-463-3716
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/18/2017
Last Update Date	:	08/31/2021

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Directions to “ MR. DANA SASSE CCC-SLP” Practice Location

Language	Start Address	Practice Location

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