Individual
MRS. TRILLA DORSEY PRUITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
42 NORTH AVE, CLEVELAND, GA 30528-1397
(706) 348-8674
Mailing address
42 NORTH AVE, CLEVELAND, GA 30528-1397
(706) 348-8674
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
LPC005278
GA
Other
Enumeration date
02/05/2009
Last updated
02/05/2009
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