| Doctor Name: | LEEANN MARIE PRADO |
| NPI Number: | 1114322948 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | SLP-A |
| License Number: | 78 |
| Business Practice Address: | 1200 E Pecan St Altus, OK - 735216141 |
| Business Phone Number: | 5803795820 |
| Business Fax Number: | 5803795829 |
| Mailing Address: | 1200 E Pecan St, ALTUS |
| State: | OK |
| Postal Code: | 735216141 |
| Phone Number: | 5803795820 |
| Fax Number: | 5803795829 |
| NPI Enumeration Date: | 10/22/2014 |
| NPI Last Update Date: | 10/22/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2355S0801X |
| License Number: | 78 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OK |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Specialist/Technologist |
| Taxonomy Specialization: | Speech-Language Assistant |
| Taxonomy Definition: | |