Provider Demographics
NPI:1225868573
Name:PRAWDZIK, ANDREAS MELVIN
Entity type:Individual
Prefix:
First Name:ANDREAS
Middle Name:MELVIN
Last Name:PRAWDZIK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 APPIAN WAY
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:MI
Mailing Address - Zip Code:48858-4382
Mailing Address - Country:US
Mailing Address - Phone:734-827-4144
Mailing Address - Fax:
Practice Address - Street 1:504 PINE AVE
Practice Address - Street 2:
Practice Address - City:ALMA
Practice Address - State:MI
Practice Address - Zip Code:48801-1723
Practice Address - Country:US
Practice Address - Phone:989-285-9122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-02
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician