Individual
KIMBERLY NICCOLE PRUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
5225 OLD ORCHARD RD, SUITE 37, SKOKIE, IL 60077-4405
(773) 474-9082
Mailing address
1961 W SUMMERDALE AVE, 2, CHICAGO, IL 60640-1040
(773) 474-9082
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
166.000945
IL
Other
Enumeration date
09/22/2011
Last updated
01/27/2014
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