Healthcare Provider Details

I. General information

NPI: 1346150612
Provider Name (Legal Business Name): MISS RITA M PRYOR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1757 PARKFORD LN
COLUMBUS OH
43229-7091
US

IV. Provider business mailing address

1757 PARKFORD LN
COLUMBUS OH
43229-7091
US

V. Phone/Fax

Practice location:
  • Phone: 614-726-0140
  • Fax:
Mailing address:
  • Phone: 614-726-0140
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number5661087
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: