Kenneth Lamar Prust, LCSW
NPI #1134113178 in Beaver Dam, Wisconsin
Provider Information
- NPI Number
- 1134113178
- Entity Type
- Individual
- Name
- Kenneth Lamar Prust, LCSW
- Gender
- Not Specified
- Sole Proprietor
- Not Answered
- Primary Specialty
- Counselor - Mental Health
- Credential
- LCSW
- Enumeration Date
- Sep 6, 2005
- Last Updated
- Jul 9, 2007
Practice Location
- Address
- 1200 N CENTER ST
- City
- Beaver Dam
- State
- Wisconsin
- ZIP Code
- 53916-1148
- Phone
- (920) 887-3171
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Mental Health — Mental Health |
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