Individual
KAREN DIANNE PRUITT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11746 FM 2767, TYLER, TX 75708-4831
(903) 574-6929
Mailing address
9846 HWY 31 E, TYLER, TX 75705-2329
(903) 752-1611
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
510174
TX
Other
Enumeration date
07/15/2014
Last updated
07/15/2014
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