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Individual
MR. CRAIG A. PRUITT
Active
Individual
MR. CRAIG A. PRUITT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
12774
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5057LC
BCBS
TX
01
—
5630133
AETNA PROVIDER NUMBER
TX
Enumeration date
09/16/2005
Last updated
03/26/2024
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