Individual
MR. JOHN PRUETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BCBA
Contact information
Practice address
7420 FULLERTON RD STE 104, SPRINGFIELD, VA 22153-2836
(703) 463-7174
(781) 437-1200
Mailing address
7420 FULLERTON RD STE 104, SPRINGFIELD, VA 22153-2836
(703) 463-7174
(781) 437-1200
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
3108
MA
103K00000X
Behavior Analyst
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019866200
—
FL
Enumeration date
06/10/2019
Last updated
03/25/2024
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