Individual
MS. SHEANA J PRYOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2215 PORTLAND AVE, LOUISVILLE, KY 40212-1033
(502) 953-4700
Mailing address
PO BOX 950244, LOUISVILLE, KY 40295-0244
(502) 953-4700
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
255189
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30615058
—
KY
Enumeration date
11/13/2007
Last updated
09/11/2020
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