Individual
SHANITHA NIMALI GUNAWARDENA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10716 LA TUNA CANYON RD, SUN VALLEY, CA 91352-2130
(818) 252-5863
Mailing address
10716 LA TUNA CANYON RD, SUN VALLEY, CA 91352-2130
(818) 252-5863
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
SPA 3109
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SPA 3109
CALIFORNIA STATE LICENSE NUMBER SLPA
CA
Enumeration date
07/23/2015
Last updated
02/08/2019
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