Healthcare Provider Details

I. General information

NPI: 1699499103
Provider Name (Legal Business Name): MANASI MOKASHI BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2022
Last Update Date: 09/28/2022
Certification Date: 09/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4601 OLD SHEPARD PL
PLANO TX
75093-5279
US

IV. Provider business mailing address

4440 STATE HIGHWAY 121 APT 351
LEWISVILLE TX
75056-5142
US

V. Phone/Fax

Practice location:
  • Phone: 214-336-6659
  • Fax:
Mailing address:
  • Phone: 469-469-0797
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: