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Individual

MRS. HELKI C. PRUITT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.ED. CCC-SLP

Contact information

Practice address
4295 BURGOMEISTER PL, SNELLVILLE, GA 30039-5905
(770) 827-8622
(770) 736-3110
Mailing address
PO BOX 390924, SNELLVILLE, GA 30039-0016
(770) 827-8622
(770) 736-3110

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP005472
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10034844
AMERIGROUP CORP. PROVI ID
GA
01
308949
WELLCARE OF GA PROVIDERID
GA
Enumeration date
12/13/2006
Last updated
07/09/2007
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