Provider Demographics
NPI:1306595160
Name:PRADO, JULIA
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:PRADO
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 1:417 CLAREMONT DR
Mailing Address - Street 2:
Mailing Address - City:EL DORADO
Mailing Address - State:AR
Mailing Address - Zip Code:71730-2901
Mailing Address - Country:US
Mailing Address - Phone:870-315-1549
Mailing Address - Fax:
Practice Address - Street 1:417 CLAREMONT DR
Practice Address - Street 2:
Practice Address - City:EL DORADO
Practice Address - State:AR
Practice Address - Zip Code:71730-2901
Practice Address - Country:US
Practice Address - Phone:870-315-1549
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-21
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer