Individual
HEATHER W PRUNTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
101 KATELYN CIR STE C, WARNER ROBINS, GA 31088-6484
(678) 664-8742
(844) 853-5737
Mailing address
719 BRODERICK CIR, WARNER ROBINS, GA 31088-2415
(478) 919-8904
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
LPC007092
GA
101YM0800X
Mental Health Counselor
LPC007092
GA
101YP2500X
Professional Counselor
Primary
LPC007092
GA
106H00000X
Marriage & Family Therapist
LPC007092
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003152827A
—
GA
Enumeration date
08/21/2013
Last updated
03/30/2021
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