Individual
DANIELLE MARIE PRUETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
770 SE KANE ST, ROSEBURG, OR 97470-3943
(541) 464-6455
Mailing address
PO BOX 2402, ROSEBURG, OR 97470-0507
(541) 464-6455
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
07/06/2015
Last updated
07/06/2015
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