Individual
MR. RUSSELL ALLAN PRYOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
3558 BROOKSHIRE DR, SYRACUSE, UT 84075-9829
(801) 718-2889
Mailing address
3558 BROOKSHIRE DR, SYRACUSE, UT 84075-9829
(801) 718-2889
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
318362-3501
UT
Other
Enumeration date
03/11/2011
Last updated
03/11/2011
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