Individual
COURTNEY AMBER PRUETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
407 W SOUTH AVE, PONCA CITY, OK 74601-6133
(580) 749-5056
Mailing address
407 W SOUTH AVE, PONCA CITY, OK 74601-6133
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
06/07/2023
Last updated
06/07/2023
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