Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | ||
N | 101YS0200X | School Counselor |
NPI | 1124237748 |
---|---|
Provider Name | Ms. Geone Pruitt |
First Address | Los Angeles, CA 90025-3477 |
Second Address | Los Angeles, CA 90057-4303 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2007 |
Last Update Date | 08/07/2007 |