Provider Demographics
NPI:1306274543
Name:PRASAD, REENA
Entity type:Individual
Prefix:
First Name:REENA
Middle Name:
Last Name:PRASAD
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 1:3602 S 180TH ST
Mailing Address - Street 2:APT A8
Mailing Address - City:SEATAC
Mailing Address - State:WA
Mailing Address - Zip Code:98188-4367
Mailing Address - Country:US
Mailing Address - Phone:206-444-5371
Mailing Address - Fax:
Practice Address - Street 1:3602 S 180TH ST
Practice Address - Street 2:APT A8
Practice Address - City:SEATAC
Practice Address - State:WA
Practice Address - Zip Code:98188-4367
Practice Address - Country:US
Practice Address - Phone:206-444-5371
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-25
Last Update Date:2013-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst