Individual
MR. JOHN ROBERT PRUETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
146 COMMUNICATION DR, HANNIBAL, MO 63401-3672
(573) 248-1196
Mailing address
146 COMMUNICATION DR, HANNIBAL, MO 63401-3672
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2009003215
MO
Other
Enumeration date
02/20/2020
Last updated
02/20/2020
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