Individual
MS. ETTA MARIE PRUITT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
400 VISION DR, ASHEBORO, NC 27203-3855
(336) 672-5450
(336) 672-3174
Mailing address
400 VISION DR, ASHEBORO, NC 27203-3855
(336) 672-5450
(336) 672-3174
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1513
NC
Other
Enumeration date
11/21/2012
Last updated
11/21/2012
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