Individual
ALICIA PRUITT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2355 STATE ST STE 101, SALEM, OR 97301-4541
(541) 203-3867
Mailing address
1292 HIGH ST UNIT A3034, EUGENE, OR 97401-3238
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
L10934
OR
Other
Enumeration date
11/08/2017
Last updated
03/14/2023
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