Individual
ALLISA PROKOPANKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LICSW
Contact information
Practice address
6458 CITY WEST PKWY, EDEN PRAIRIE, MN 55344-3245
(952) 767-6791
(612) 728-5301
Mailing address
5253 BEARD AVE S, MINNEAPOLIS, MN 55410-2117
(952) 607-7632
(612) 728-5301
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
20444
MN
Other
Enumeration date
05/19/2014
Last updated
05/19/2014
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