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General NPI Number Information
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NPI Number | 1124460977
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Entity Type | Individual
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Provider Name | MAURA L PRATT MS, LMHC, LPC, NCC
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Gender | Female
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Dates
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Enumeration Date | 07/22/2013
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Last Update Date | 04/07/2020
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Provider Practice Location Address
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Address Line | 2410 LISENBY AVE
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City | PANAMA CITY
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State | FL
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Zip | 32405-3537
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Country | US
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Telephone | 850-640-4328
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Fax | 850-640-4319
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Provider Business Mailing Address
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Address Line | 2410 LISENBY AVE
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City | PANAMA CITY
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State | FL
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Zip | 32405-3537
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Country | US
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Telephone | 850-640-4328
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Fax | 850-640-4319
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH16415
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 3172
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License Number State | AL
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