Individual
MR. ERNEST PRUITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BA,SAC-IT
Contact information
Practice address
3707 N RICHARDS ST, MILWAUKEE, WI 53212-1673
(414) 967-7006
(414) 967-7020
Mailing address
3707 N RICHARDS ST, MILWAUKEE, WI 53212-1673
(414) 967-7006
(414) 967-7020
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
16054-130
WI
Other
Enumeration date
08/17/2011
Last updated
08/17/2011
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