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Individual

DIONNE PRUITT

Active
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Individual

DIONNE PRUITT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
103TM1800X
Intellectual & Developmental Disabilities Psychologist
172V00000X
Community Health Worker
175T00000X
Peer Specialist
222Q00000X
Developmental Therapist
225800000X
Recreation Therapist
251C00000X
Developmentally Disabled Services Day Training Agency
Primary

Other

Enumeration date
10/22/2014
Last updated
03/31/2016
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