| NPI | 1669518833 |
|---|---|
| Former Name | CARRIE LEA PRUITT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225XP0200X Occupational Therapist, Pediatrics (Licence: IA 001893) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: TX 111657) |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2010-12-29 |