Doctor Name: | MASTANEH NASSI |
NPI Number: | 1124385802 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S., CCC-SLP |
License Number: | 19111 |
Business Practice Address: | 2202 W Martin Luther King Jr Blvd Los Angeles, CA - 900082723 |
Business Phone Number: | 3106667413 |
Business Fax Number: | |
Mailing Address: | 121 N Le Doux Rd, BEVERLY HILLS |
State: | CA |
Postal Code: | 902112210 |
Phone Number: | 1310666741 |
Fax Number: | |
NPI Enumeration Date: | 04/18/2012 |
NPI Last Update Date: | 06/17/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 19111 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |