Healthcare Provider Details

I. General information

NPI: 1093659872
Provider Name (Legal Business Name): MIRIHANA ARACHCHIGE SENANI ('SENANI MARIYA PERERA-GARRITY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2026
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4900 MARYLAND AVE
GLENDALE CA
91214-1245
US

IV. Provider business mailing address

4854 HAZELTINE AVE APT 7
SHERMAN OAKS CA
91423-2330
US

V. Phone/Fax

Practice location:
  • Phone: 817-876-8183
  • Fax:
Mailing address:
  • Phone: 817-876-8183
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: