Individual
BOSTON K PROKOP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2541 PASS RD STE A, BILOXI, MS 39531-2112
(718) 215-5311
(718) 865-5165
Mailing address
2541 PASS RD STE A, BILOXI, MS 39531-2112
(718) 215-5311
(718) 865-5165
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
01/24/2022
Last updated
01/27/2026
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