Individual
MARY LOUISE PRUETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
720 N MARR RD, COLUMBUS, IN 47201
(812) 314-3400
Mailing address
645 S ROGERS ST, BLOOMINGTON, IN 47403-2353
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34004128
IN
Other
Enumeration date
02/15/2006
Last updated
07/25/2018
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