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Individual

CHERYL PRUETT II

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
115 LIBERTY ST, BATH, NY 14810-1508
(607) 776-6577
Mailing address
90 BELLE CORNELL DR, MONTOUR FALLS, NY 14865-9609

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
11297
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
38653L
NY
Enumeration date
10/16/2006
Last updated
07/08/2007
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