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Individual

DR. STEPHANY PRUITT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
6815 W CAPITOL DR STE 304, MILWAUKEE, WI 53216-2056
(414) 554-1143
(414) 355-5467
Mailing address
6815 W CAPITOL DR STE 304, MILWAUKEE, WI 53216-2056
(414) 554-1143
(414) 355-5467

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
4758-125
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1972806669
WI
Enumeration date
12/17/2010
Last updated
07/21/2022
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