Provider Demographics
NPI:1558038992
Name:PRADO, AMANDA (TND)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:PRADO
Suffix:
Gender:F
Credentials:TND
Other - Prefix:MS
Other - First Name:AMANDA
Other - Middle Name:
Other - Last Name:PRADO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:TND
Mailing Address - Street 1:5 KILEY ST
Mailing Address - Street 2:
Mailing Address - City:NORTH PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02911-2705
Mailing Address - Country:US
Mailing Address - Phone:401-999-3770
Mailing Address - Fax:
Practice Address - Street 1:5 KILEY ST
Practice Address - Street 2:
Practice Address - City:NORTH PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02911-2705
Practice Address - Country:US
Practice Address - Phone:401-999-3770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-24
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath