Individual
DR. KEVIN PROSNICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
154 HOGAN LN NE, WARREN, OH 44484-5545
(330) 423-5066
Mailing address
154 HOGAN LN NE, WARREN, OH 44484-5545
(330) 423-5066
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
5430
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2072680
—
OH
Enumeration date
04/25/2007
Last updated
08/01/2019
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