Provider Demographics
NPI:1700539954
Name:HAMMAD, SASHA
Entity type:Individual
Prefix:
First Name:SASHA
Middle Name:
Last Name:HAMMAD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANGELIC
Other - Middle Name:
Other - Last Name:XPRESSIONS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LLC
Mailing Address - Street 1:8657 BRUTON PARISH CT APT 304
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20110-4550
Mailing Address - Country:US
Mailing Address - Phone:845-770-7139
Mailing Address - Fax:
Practice Address - Street 1:8657 BRUTON PARISH CT APT 304
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-4550
Practice Address - Country:US
Practice Address - Phone:845-770-7139
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-28
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA882194349OtherID