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1558006353
STEPHAN MICHAEL PRUITT
SLIDELL, LA
NPI
1558006353
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YP2500X Counselor, Professional
(Licence: LA 7895)
Enumeration Date
2022-05-05
Last Update Date
2022-05-05
Business Address
STEPHAN MICHAEL PRUITT LPC
1258 BROWNSWITCH RD STE C
SLIDELL, LA 70461-1606
Phone number: 215-292-3425
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Mailing Address
STEPHAN MICHAEL PRUITT LPC
28 PARK PLACE DR APT 409
COVINGTON, LA 70433-8958
Phone number: 215-292-3425
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