Individual
DR. LARRY D PRUITT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
9933 W HAYES ST MADIGAN ANX, JOINT BASE LEWIS MCCHORD, TACOMA, WA 98431-0001
(253) 986-2946
Mailing address
9933 W HAYES ST MADIGAN ANX, JOINT BASE LEWIS MCCHORD, TACOMA, WA 98431-0001
(253) 986-2946
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY60239205
WA
Other
Enumeration date
01/03/2013
Last updated
01/03/2013
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