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Search › Minnesota › 1041C0700X

Tara Prom, LICSW

NPI 1205338969 · on the registry since 2018

Practice

Address
22 Wilson Ave Ne Suite 110
Po Box 6069
Saint Cloud, MN 56302
Phone
(320) 251-7700
Fax
(320) 251-8898
Organisation at this address
Medway Transit Llc
Med Transit Solutions
Aba Community Care Llc
Miracle 3d Moments, Llc
Natural Lee Speaking Inc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
27

Registry record

Primary taxonomy
1041C0700X
1041C0700X
Also registered as
101YS0200X
Licence states on file
MN
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2018-03-08

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Minnesota