Individual
ELLEN PRUSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
2300 GALLBERRY LN, WAXHAW, NC 28173-0161
(704) 290-6397
Mailing address
2300 GALLBERRY LN, WAXHAW, NC 28173-0161
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
30004122
NC
235Z00000X
Speech-Language Pathologist
Primary
30004898
NC
Other
Enumeration date
06/16/2025
Last updated
07/09/2026
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