Provider Demographics
NPI:1609181775
Name:NAIDOO, MAHASHINI (PT)
Entity Type:Individual
Prefix:MS
First Name:MAHASHINI
Middle Name:
Last Name:NAIDOO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 US HWY 51 BYPASS N, PMB 574
Mailing Address - Street 2:
Mailing Address - City:DYERSBURG
Mailing Address - State:TN
Mailing Address - Zip Code:38024-1950
Mailing Address - Country:US
Mailing Address - Phone:731-334-2919
Mailing Address - Fax:
Practice Address - Street 1:1445 PARR AVE
Practice Address - Street 2:
Practice Address - City:DYERSBURG
Practice Address - State:TN
Practice Address - Zip Code:38024-3153
Practice Address - Country:US
Practice Address - Phone:731-334-2919
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-13
Last Update Date:2020-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPT0000005228225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist