Individual
CORRINE PATRICIA PRUITT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
13100 WAYZATA BLVD STE 200, MINNETONKA, MN 55305-1810
(952) 206-2040
Mailing address
2250 PLYMOUTH RD APT 307, HOPKINS, MN 55305-2351
(763) 229-9234
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
27009
MN
Other
Enumeration date
04/22/2022
Last updated
05/25/2022
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