Provider Demographics
NPI:1215298609
Name:THERAPY MANTRA, INC
Entity type:Organization
Organization Name:THERAPY MANTRA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MR
Authorized Official - First Name:SATISH
Authorized Official - Middle Name:
Authorized Official - Last Name:KRISHNAPPA
Authorized Official - Suffix:
Authorized Official - Credentials:MS,CCC-SLP
Authorized Official - Phone:909-248-0184
Mailing Address - Street 1:2031 NORDIC AVE
Mailing Address - Street 2:
Mailing Address - City:CHINO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91709-4769
Mailing Address - Country:US
Mailing Address - Phone:909-248-0184
Mailing Address - Fax:909-248-0184
Practice Address - Street 1:2031 NORDIC AVE
Practice Address - Street 2:
Practice Address - City:CHINO HILLS
Practice Address - State:CA
Practice Address - Zip Code:91709-4769
Practice Address - Country:US
Practice Address - Phone:909-248-0184
Practice Address - Fax:909-248-0184
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-03
Last Update Date:2012-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15962251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)