Pratt, Penelope Kathleen
Pratt, Penelope Kathleen is an sole proprietor health care provider with primary practice located at 3501 E Main St , Farmington NM 87402-5153. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Pratt, Penelope Kathleen can be contacted via phone (505) 258-4457.Contact Information
Primary practice address
3501 E Main St
Farmington NM 87402-5153
Phone: (505) 258-4457
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 2023-0884 | New Mexico |
Profile Details
| NPI number | 1417385337 |
|---|---|
| LBN Legal business name | Pratt, Penelope Kathleen |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 31st, 2013 |
| Last updated | Oct 12th, 2023 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1417385337 | NPPES |
| New Mexico | Other | 2023-0884 | NM SW LICENSE |
| New Mexico | Other | 126548 | NM SW LICENSE |
| New Mexico | Other | 15987084 | NM SW LICENSE |
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