Most Relevant Information
Provider Data
| NPI Number: | 1003007790 |
| Provider Name: | MARK PRUDEN L.P.C.C. |
| Entity Type: | Individual |
| Taxonomy Code: | 101YP2500X |
| Specialty: | Counselor |
| License Number: | E1734 |
Most Important Dates
| Enumeration Date: | 08/07/2007 |
| Last Updated: | 04/23/2021 |
Provider Practice Location
42 CALHOUN ST
CINCINNATI
OH
452191525
Practice Location Phone/Fax
| Phone: | 5138616543 |
| Fax: | 5133810016 |
Provider Mailing Location
PO BOX 19971
CINCINNATI
OH
452190971
Provider Mailing Phone/Fax
| Phone: | 5138616543 |
| Fax: | 5133810016 |