Provider Demographics
NPI:1225318850
Name:PRADO, MELISSA SALOME (JD)
Entity Type:Individual
Prefix:MISS
First Name:MELISSA
Middle Name:SALOME
Last Name:PRADO
Suffix:
Gender:F
Credentials:JD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 SPRINGFIELD DR
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80521-4349
Mailing Address - Country:US
Mailing Address - Phone:307-221-0745
Mailing Address - Fax:
Practice Address - Street 1:2001 SPRINGFIELD DR
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80521-4349
Practice Address - Country:US
Practice Address - Phone:307-221-0745
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-26
Last Update Date:2011-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator