Individual
CARL PRATT JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSMHC
Contact information
Practice address
109 LIVE OAKS BLVD, 0605, CASSELBERRY, FL 32707-3827
(407) 986-0377
Mailing address
109 LIVE OAKS BLVD, 0605, CASSELBERRY, FL 32707-3827
(407) 986-0377
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
NONE
FL
172A00000X
Driver
P630139743438
FL
376J00000X
Homemaker
234582
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
016291000
PROVIDER NUMBER
FL
Enumeration date
08/23/2016
Last updated
11/04/2016
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