Individual
JENNIFER PRUITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
630 E SOUTHLAKE BLVD STE 112, SOUTHLAKE, TX 76092-6259
(214) 494-6287
Mailing address
4704 ARGYLE LN, ARGYLE, TX 76226-1517
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
74770
TEXAS STATE BOARD OF EXAMINERS
TX
Enumeration date
03/28/2018
Last updated
03/28/2018
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