| NPI | 1639790199 |
|---|---|
| Former Name | LISA MARIE PRUITT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: OH E.2303925) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: OH C.2002426-TRNE) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OR 20-QMHA-R-0504) | |
| 101YM0800X Counselor Mental Health (Licence: OR R7199) | |
| Enumeration Date | 2020-05-06 |
| Last Update Date | 2024-01-30 |