Provider Demographics
NPI:1770176422
Name:MOHAN, MARIA F
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:F
Last Name:MOHAN
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 1:5838 FLAMBEAU RD
Mailing Address - Street 2:
Mailing Address - City:RANCHO PALOS VERDES
Mailing Address - State:CA
Mailing Address - Zip Code:90275-2155
Mailing Address - Country:US
Mailing Address - Phone:424-245-9502
Mailing Address - Fax:
Practice Address - Street 1:8 SNOW RD
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03470-2806
Practice Address - Country:US
Practice Address - Phone:603-239-6355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-13
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54282355S0801X
MA100896235Z00000X
NHEL32065235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language AssistantGroup - Single Specialty