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General NPI Number Information
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NPI Number | 1568757755
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Entity Type | Individual
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Provider Name | MICHELLE D PRADO LCSW
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Gender | Female
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Dates
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Enumeration Date | 06/15/2011
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Last Update Date | 08/21/2015
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Provider Practice Location Address
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Address Line | 2777 N STEMMONS FWY STE 825
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City | DALLAS
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State | TX
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Zip | 75207-2508
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Country | US
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Telephone | 214-704-4338
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Fax |
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Provider Business Mailing Address
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Address Line | 325 KESWICK LN
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City | MESQUITE
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State | TX
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Zip | 75150-8215
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Country | US
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Telephone | 214-293-5567
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | 53449
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License Number State | TX
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