Provider Demographics
NPI:1801123344
Name:PRUITT, MARGARET A (OTR/L)
Entity type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:A
Last Name:PRUITT
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3810 WARWICK LN
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75082-2898
Mailing Address - Country:US
Mailing Address - Phone:972-480-8545
Mailing Address - Fax:
Practice Address - Street 1:86 VALLEY HIDEAWAY DR
Practice Address - Street 2:SUITE 280
Practice Address - City:HAYESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28904-9674
Practice Address - Country:US
Practice Address - Phone:877-219-1029
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-04
Last Update Date:2009-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7289225XP0019X
TX112655225XP0019X
VA0119005015225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation