Individual
GROVER PAUL PRIDMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.ED., LMHC
Contact information
Practice address
1008 W IVY AVE, MOSES LAKE, WA 98837-2049
(509) 322-0993
Mailing address
1008 W IVY AVE, MOSES LAKE, WA 98837-2049
(509) 322-0993
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
9746
WA
Other
Enumeration date
08/01/2007
Last updated
09/22/2009
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