Individual
KIMBERLY PRUITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
203 MISTY HILL TRL, DALLAS, GA 30132-1197
(404) 234-2955
(949) 561-4560
Mailing address
203 MISTY HILL TRL, DALLAS, GA 30132-1197
(404) 234-2955
(949) 561-4560
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
06/22/2021
Last updated
06/22/2021
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