Provider Information for 1144991530
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KEITH PRYOR LPCA
Other Names:Professional Name:KEITH PRYORSex: Male
NPI: 1144991530
Last Updated: 2022-09-21
Certification Date: 2022-09-21
Certification Date: 2022-09-21
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1144991530 | ||||||||||||
| Enumeration Date | 2021-09-24 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 16 LANDERS RD EAST HARTFORD, CT 06118-3318 United States Phone: 860-595-2674 | Fax: | ||||||||||||
| Primary Practice Address | 1080 ELM ST ROCKY HILL, CT 06067-1844 United States Phone: 860-831-3298 | Fax: | ||||||||||||
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