Provider Demographics
NPI:1346851458
Name:PRASAD-DEHANEY, MELANIE N (NBC-HWC)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:N
Last Name:PRASAD-DEHANEY
Suffix:
Gender:F
Credentials:NBC-HWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2150 INDIAN IVEY LN
Mailing Address - Street 2:
Mailing Address - City:DACULA
Mailing Address - State:GA
Mailing Address - Zip Code:30019-3303
Mailing Address - Country:US
Mailing Address - Phone:678-480-6334
Mailing Address - Fax:
Practice Address - Street 1:2150 INDIAN IVEY LN
Practice Address - Street 2:
Practice Address - City:DACULA
Practice Address - State:GA
Practice Address - Zip Code:30019-3303
Practice Address - Country:US
Practice Address - Phone:678-480-6334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-12
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date: