# GARY V PRATER

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1922011253
- **Gender:** Man
- **Credential:** PSY D

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103T00000X | Psychologist | 0571 | KY | Yes |

## Other

- **Enumeration date:** 08/15/2006
- **Last updated:** 11/07/2014

## 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 |