Individual
MCKENZIE BETH PRUTSMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
351 TENNY ST, BLOOMSBURG, PA 17815-3264
(888) 726-4774
Mailing address
351 TENNY ST, BLOOMSBURG, PA 17815-3264
(570) 802-3099
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
PA
Other
Enumeration date
10/21/2020
Last updated
11/18/2020
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