Individual
JOHN PROHASKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
13549 N SANDERS RD, MARANA, AZ 85653-9505
(520) 682-1091
(520) 682-4132
Mailing address
PO BOX 188, MARANA, AZ 85653-0188
(520) 682-4111
(520) 682-4570
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-0494
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
757924
—
AZ
Enumeration date
09/20/2006
Last updated
09/07/2011
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