Provider Demographics
NPI:1356856470
Name:MANTRIPRAGADA, SNEHA
Entity Type:Individual
Prefix:
First Name:SNEHA
Middle Name:
Last Name:MANTRIPRAGADA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2218 CENTRAL PARK AVE APT 4
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10710-1852
Mailing Address - Country:US
Mailing Address - Phone:805-638-2255
Mailing Address - Fax:
Practice Address - Street 1:7 N CROSSING WAY
Practice Address - Street 2:
Practice Address - City:BETHEL
Practice Address - State:CT
Practice Address - Zip Code:06801-1660
Practice Address - Country:US
Practice Address - Phone:805-638-2255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-12
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026769235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist