Individual
MARK PRATT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4874 LONG BEACH RD SE, SOUTHPORT, NC 28461-8713
(607) 760-7753
Mailing address
1003 OSPREY CIR, SOUTHPORT, NC 28461-2669
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
9071A
NC
Other
Enumeration date
03/13/2014
Last updated
05/06/2015
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