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General NPI Number Information
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NPI Number | 1942478169
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Entity Type | Individual
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Provider Name | SANDRA A MANDILAS OTR/L
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Gender | Female
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Dates
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Enumeration Date | 02/11/2008
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Last Update Date | 07/06/2010
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Provider Practice Location Address
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Address Line | 14514 SANDALIN DR
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City | CYPRESS
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State | TX
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Zip | 77429-1862
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Country | US
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Telephone | 716-984-2649
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Fax |
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Provider Business Mailing Address
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Address Line | 14514 SANDALIN DR
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City | CYPRESS
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State | TX
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Zip | 77429-1862
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Country | US
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Telephone | 716-984-2649
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XF0002X
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Taxonomy Name | Feeding, Eating & Swallowing Occupational Therapist
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License Number | 113096
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 113096
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License Number State | TX
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