person
Blake Prochnow
Addiction (Substance Use Disorder) Counselor in Prescott, Wisconsin
NPI 1164093860

Blake Prochnow is an Addiction (Substance Use Disorder) Counselor based in New Brighton, WI and is specialized in Addiction (Substance Use Disorder). Blake Prochnow practices in Prescott, WI. The NPI Number for Blake Prochnow is 1164093860 and holds a License No. (Wisconsin).

The current practice location address for Blake Prochnow is 1380 Walnut St, Prescott, WI and can be reached out via phone at 612-382-3458.

Location: 1380 Walnut St, Prescott, WI, 55112-1789
person
Provider Profile Details
NPI Number
1164093860
Provider Name
Blake Prochnow
Credential
Provider Entity Type
Individual
Gender
Male
Address
1380 Walnut St, Prescott, WI, 55112-1789
Phone Number
612-382-3458
Fax Number
Provider Enumeration Date
07/05/2021
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
540321 05 MN
institution
Provider Business Practice Location Address Details
Address
1380 Walnut St
City
State
Zip
54021-1010
Phone Number
612-382-3458
Fax Number
person
Provider Business Mailing Address Details
Address
1380 Walnut St
City
State
Zip
54021-1010
Phone Number
612-382-3458
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
()
Definition
Definition to come...
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