Individual
BETHANY PRUITT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9096 REXIS AVE, PERRY HALL, MD 21128-9021
(443) 453-2031
(443) 216-7397
Mailing address
308 FOLCROFT ST, BALTIMORE, MD 21224-2801
(443) 453-2031
(443) 216-7397
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-20-112677
MD
Other
Enumeration date
05/20/2021
Last updated
10/26/2022
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