Individual
REVONDA KISER PRUITT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS CCC-SLP
Contact information
Practice address
502 W HOOD ST, PIEDMONT, AL 36272-1530
(256) 447-9481
Mailing address
11310 US HIGHWAY 278 E, PIEDMONT, AL 36272-8365
(256) 310-9352
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1685
AL
Other
Enumeration date
09/10/2018
Last updated
09/10/2018
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