Provider Demographics
NPI:1013764802
Name:PRABHU, SWATHI
Entity type:Individual
Prefix:
First Name:SWATHI
Middle Name:
Last Name:PRABHU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 GOLD LEAF DR
Mailing Address - Street 2:
Mailing Address - City:CHRISTIANSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24073-7641
Mailing Address - Country:US
Mailing Address - Phone:828-514-8464
Mailing Address - Fax:
Practice Address - Street 1:165 GOLD LEAF DR
Practice Address - Street 2:
Practice Address - City:CHRISTIANSBURG
Practice Address - State:VA
Practice Address - Zip Code:24073-7641
Practice Address - Country:US
Practice Address - Phone:828-514-8464
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-01
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling