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1174803506
ERNEST PRUITT
MILWAUKEE, WI
NPI
1174803506
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WI 16054-130)
Enumeration Date
2011-08-17
Last Update Date
2011-08-17
Business Address
Mr. ERNEST PRUITT BA,SAC-IT
3707 N RICHARDS ST
MILWAUKEE, WI 53212-1673
Phone number: 414-967-7006
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Mailing Address
Mr. ERNEST PRUITT BA,SAC-IT
3707 N RICHARDS ST
MILWAUKEE, WI 53212-1673
Phone number: 414-967-7006
Copy
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