Provider Demographics
NPI:1447123260
Name:PRADOS-ISTRE, LEAH (LMT)
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:PRADOS-ISTRE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 GUSSIE DR
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-6301
Mailing Address - Country:US
Mailing Address - Phone:337-255-5598
Mailing Address - Fax:
Practice Address - Street 1:115 GUSSIE DR
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-6301
Practice Address - Country:US
Practice Address - Phone:337-255-5598
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-26
Last Update Date:2025-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4138225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist