Blake Prochnow, | |
1380 Walnut St, Prescott, WI 54021-1010 | |
(612) 382-3458 | |
Not Available |
Full Name | Blake Prochnow |
---|---|
Gender | Male |
Speciality | Counselor - Addiction (substance Use Disorder) |
Location | 1380 Walnut St, Prescott, Wisconsin |
Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1164093860 | NPI | - | NPPES |
540321 | Medicaid | MN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
---|---|
Blake Prochnow, 1900 Silver Lake Rd Nw Ste 110, New Brighton, MN 55112-1789 Ph: (651) 379-1752 | Blake Prochnow, 1380 Walnut St, Prescott, WI 54021-1010 Ph: (612) 382-3458 |
Charles Kaltenberg, Counselor Medicare: Not Enrolled in Medicare Practice Location: N5531 1245th St, Prescott, WI 54021 Phone: 612-584-9071 | |
Diana Devries, Counselor Medicare: Not Enrolled in Medicare Practice Location: N5813 1110th St, Prescott, WI 54021 Phone: 715-441-0072 |