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NPI 1174826523

NPI 1174826523 : DONNA J PRYOR MSSW, LCSW : LOUISVILLE, KY

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General NPI Number Information
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    NPI Number           |    1174826523
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    Entity Type          |    Individual 
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    Provider Name        |    DONNA J PRYOR MSSW, LCSW
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    12/07/2010
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    Last Update Date     |    12/07/2015
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Provider Practice Location Address
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    Address Line         |    2520 BARDSTOWN RD SUITE 8
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    City                 |    LOUISVILLE
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    State                |    KY
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    Zip                  |    40205-2672
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    Country              |    US
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    Telephone            |    502-693-5070
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2520 BARDSTOWN RD SUITE 8
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    City                 |    LOUISVILLE
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    State                |    KY
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    Zip                  |    40205-2672
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    Country              |    US
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    Telephone            |    502-693-5070
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    Fax                  |    
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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        |    1041C0700X
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    Taxonomy Name        |    Clinical Social Worker
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    License Number       |    4052
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    License Number State |    KY
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Taxonomy #2
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    Taxonomy Code        |    1041C0700X
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    Taxonomy Name        |    Clinical Social Worker
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    License Number       |    33005888A
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    License Number State |    IN
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