| Doctor Name: | JOAN E PRUGH |
| NPI Number: | 1114011160 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MSW |
| License Number: | 000531 |
| Business Practice Address: | 12c Ledgebrook Dr Ste 2 Mansfield Center, CT - 062501664 |
| Business Phone Number: | 8604509789 |
| Business Fax Number: | 8604873617 |
| Mailing Address: | 12c Ledgebrook Dr Ste 2, MANSFIELD CENTER |
| State: | CT |
| Postal Code: | 062501664 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 10/03/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 000531 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CT |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |