Provider Demographics
NPI:1710377569
Name:PRADOS, MEGAN ALANE (MCD, SLP-CFY)
Entity Type:Individual
Prefix:MISS
First Name:MEGAN
Middle Name:ALANE
Last Name:PRADOS
Suffix:
Gender:F
Credentials:MCD, SLP-CFY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5100 TOBY LN
Mailing Address - Street 2:
Mailing Address - City:KENNER
Mailing Address - State:LA
Mailing Address - Zip Code:70065-3264
Mailing Address - Country:US
Mailing Address - Phone:504-554-1923
Mailing Address - Fax:
Practice Address - Street 1:4704 JANICE AVE
Practice Address - Street 2:
Practice Address - City:KENNER
Practice Address - State:LA
Practice Address - Zip Code:70065-3339
Practice Address - Country:US
Practice Address - Phone:504-455-0983
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-02
Last Update Date:2015-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA7196235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist