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Individual
PAULINE C PRUITT
Active
Individual
PAULINE C PRUITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904003271
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4945361
—
VA
Enumeration date
09/08/2006
Last updated
06/13/2008
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