| NPI | 1184100844 |
|---|---|
| Former Name | KELSEY SUE PRUITT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: OH APRN.CNP.0027462) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2018-07-16 |
| Last Update Date | 2023-10-26 |