Individual
JENNA PRUSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
513 5TH ST SW, WILLMAR, MN 56201-3216
(320) 214-9692
(320) 214-9924
Mailing address
420 KELLOGG AVE, AMES, IA 50010-6226
(515) 233-2250
(515) 233-3235
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
20800
MN
Other
Enumeration date
11/15/2013
Last updated
11/14/2018
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