Most Relevant Information
Provider Data
| NPI Number: | 1003659301 |
| Provider Name: | TERESA GAIL PRATER PSS |
| Entity Type: | Individual |
| Taxonomy Code: | 175T00000X |
| Specialty: | Peer Specialist |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/14/2024 |
| Last Updated: | 06/14/2024 |
Provider Practice Location
125 S MAIN CROSS ST
LOUISA
KY
412301065
Practice Location Phone/Fax
| Phone: | 6066390938 |
| Fax: |
Provider Mailing Location
125 S MAIN CROSS ST
LOUISA
KY
412301065
Provider Mailing Phone/Fax
| Phone: | 6066390938 |
| Fax: |