MR. Jeffrey David Prusa, MA, LPC, LCPC

NPI #1245372424 in Vinita, Oklahoma

Provider Information

NPI Number: 1245372424
Entity Type: Individual
Name: MR. Jeffrey David Prusa, MA, LPC, LCPC
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor - Professional
Credential: MA, LPC, LCPC
Enumeration Date: Feb 13, 2007
Last Updated: Sep 10, 2012

Practice Location

Address: 1520 INDUSTRIAL AVE
City: Vinita
State: Oklahoma
ZIP Code: 74301-4803
Phone: (918) 256-7518

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Professional — Professional	101YP2500X	Primary

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