Provider Demographics
NPI:1801279849
Name:WARREN, RASHEDA L
Entity type:Individual
Prefix:
First Name:RASHEDA
Middle Name:L
Last Name:WARREN
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 1:4683 BETTS DR STE 403
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75052-1807
Mailing Address - Country:US
Mailing Address - Phone:214-934-9979
Mailing Address - Fax:
Practice Address - Street 1:4683 BETTS DR STE 403
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75052-1807
Practice Address - Country:US
Practice Address - Phone:214-934-9979
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-08
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251B00000X
TX70696101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No251B00000XAgenciesCase Management