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Individual
GARY V PRATER
Active
Individual
GARY V PRATER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY D
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
0571
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000224318
ANTHEM BCBS
—
01
—
001723355
MSBCBS
—
05
—
0871463
—
OH
01
—
10983
CHA
—
01
—
11726241
CAQH
—
01
—
227484
MANAGED HEALTH
—
05
—
7100283070
—
KY
Enumeration date
08/15/2006
Last updated
11/07/2014
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