Individual
ELIZABETH PRUITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED
Contact information
Practice address
9403 MANSFIELD RD, SHREVEPORT, LA 71118-3815
(318) 861-8938
Mailing address
PO BOX 29372, SHREVEPORT, LA 71149-9372
(318) 670-8898
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
09/19/2016
Last updated
06/03/2022
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