Individual
SERENITY PRUITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
111 GREYSTONE DR, GREENBRIER, AR 72058-9810
(501) 944-0498
Mailing address
2015 RUMKER RD, CONWAY, AR 72032-4506
(501) 294-8533
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
AR
Other
Enumeration date
10/23/2024
Last updated
10/23/2024
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