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NPI Code Detail

MEDICARE: PORSHA PRATT

MEDICARE: PORSHA PRATT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator
2101YA0400XAddiction (Substance Use Disorder) Counselor000313489OH

General Provider Information

NPI Number : 1154968964
Entity Type Code : Individual
Provider Name (Legal Business Name) : PORSHA PRATT
Provider Business Mailing Address
First Line : 3829 WOODLEY RD STE B6
Second Line :
City : TOLEDO
State : OH
Zip : 43606-1174
Country : US
Telephone Number : 419-690-4544
Fax Number :
Provider Business Practice Location Address
First Line : 3829 WOODLEY RD STE B6
Second Line :
City : TOLEDO
State : OH
Zip : 43606-1174
Country : US
Telephone Number : 419-902-2441
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/30/2019
Last Update Date : 09/11/2025

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Directions to “ PORSHA PRATT ” Practice Location

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