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General NPI Number Information
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NPI Number | 1821689589
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Entity Type | Organization
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Legal Business Name | PRUITT THERAPY SERVICES LLC
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Dates
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Enumeration Date | 01/26/2021
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Last Update Date | 10/03/2023
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Provider Practice Location Address
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Address Line | 1605 PRATER ST
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City | DAYTON
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State | TX
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Zip | 77535-6819
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Country | US
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Telephone | 832-506-3839
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Fax |
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Provider Business Mailing Address
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Address Line | 1605 PRATER ST
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City | DAYTON
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State | TX
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Zip | 77535-6819
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Country | US
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Telephone | 832-506-3839
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | BRITTANY PRUITT
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Credential | CCC-SLP
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Telephone | 832-341-6088
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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