KENNETH PRUST, LCSW

Counselor - Mental Health

Active Individual
NPI: 1134113178

Practice Address

1200 N CENTER ST
Beaver Dam, WI 53916

Phone: (920) 887-3171

Specialties

Specialty Code Primary License
Counselor - Mental Health 101YM0800X Yes 6795-123 (WI)

Frequently Asked Questions

NPI 1134113178 is the National Provider Identifier for KENNETH PRUST, LCSW, a Counselor - Mental Health provider located in Beaver Dam, WI. This NPI was enumerated on September 6, 2005.
KENNETH PRUST, LCSW practices at 1200 N CENTER ST, Beaver Dam, WI 53916.

Quick Facts

NPI
1134113178
Type
Individual
Enumerated
Sep 6, 2005
Last Updated
Jul 9, 2007

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