Individual
SREELATHA MANDADI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
5100 MARNA LYNN AVE NW, ALBUQUERQUE, NM 87114-5701
(505) 898-0923
Mailing address
5100 MARNA LYNN AVE NW, ALBUQUERQUE, NM 87114-5701
(505) 898-0923
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
C 4939
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NONE ASSIGNED
—
NM
Enumeration date
10/04/2011
Last updated
10/04/2011
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