| Doctor Name: | STACY PRUITT |
| NPI Number: | 1346547429 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | SLP |
| License Number: | SP-9821 |
| Business Practice Address: | 25221 Miles Rd Unit F Warrensville Heights, OH - 441285494 |
| Business Phone Number: | 2165141600 |
| Business Fax Number: | 2162923291 |
| Mailing Address: | 25221 Miles Rd Unit F, WARRENSVILLE HEIGHTS |
| State: | OH |
| Postal Code: | 441285494 |
| Phone Number: | 2165141600 |
| Fax Number: | 2162923291 |
| NPI Enumeration Date: | 02/25/2011 |
| NPI Last Update Date: | 10/11/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | SP-9821 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |