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Individual

KYLIE PRATHER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
4002 124TH ST, LUBBOCK, TX 79423-8902
(806) 215-1886
Mailing address
4002 124TH ST, LUBBOCK, TX 79423-8902
(806) 215-1886

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
83415
TX

Other

Enumeration date
06/17/2022
Last updated
06/17/2022
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