Individual
MR. BRETT JOSEPH PRUNTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.ED LPC CRC CADC II
Contact information
Practice address
731 NW FRANKLIN AVE STE 107, BEND, OR 97701-2752
(541) 610-2512
Mailing address
731 NW FRANKLIN AVE STE 107, BEND, OR 97701-2752
(541) 610-2512
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CADC II # 05-R-03
OR
101YM0800X
Mental Health Counselor
Primary
LPC (OR) C-1765
OR
Other
Enumeration date
02/07/2008
Last updated
02/07/2008
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