Provider Demographics
NPI:1669658324
Name:MANGHANI, MAHESH M (BSCOT; OT(C); OTR/L)
Entity Type:Individual
Prefix:MR
First Name:MAHESH
Middle Name:M
Last Name:MANGHANI
Suffix:
Gender:M
Credentials:BSCOT; OT(C); OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 GRANBURY LN
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29229-7589
Mailing Address - Country:US
Mailing Address - Phone:803-788-1950
Mailing Address - Fax:803-788-1950
Practice Address - Street 1:216 GRANBURY LN
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29229-7589
Practice Address - Country:US
Practice Address - Phone:803-788-1950
Practice Address - Fax:803-788-1950
Is Sole Proprietor?:No
Enumeration Date:2008-01-12
Last Update Date:2015-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1758225X00000X, 225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand