Individual
NICOLE ANN PROKASH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
1040 PILGRIM WAY, ASHWAUBENON, WI 54304-5028
(920) 405-3522
Mailing address
543 HILL RD, GREENLEAF, WI 54126-9632
(920) 205-9757
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
4928-026
WI
Other
Enumeration date
12/14/2010
Last updated
09/07/2022
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