Individual
MRS. MICAELA ELIZABETH PRUIETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
322 S LAURA AVE, WICHITA, KS 67211-1517
(419) 331-6789
Mailing address
116 W PAWNEE AVE, WICHITA, KS 67213-4815
(903) 747-0869
(316) 453-4173
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
04798-T
KS
Other
Enumeration date
09/26/2024
Last updated
09/26/2024
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