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1730828088
AMANDA GRACE PRUSOW
BROOKFIELD, WI
NPI
1730828088
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
103TB0200X Psychologist Cognitive & Behavioral
Enumeration Date
2022-06-02
Last Update Date
2022-06-02
Business Address
AMANDA GRACE PRUSOW
200 N PATRICK BLVD UNIT 250
BROOKFIELD, WI 53045-5883
Phone number: 888-754-0398
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Mailing Address
AMANDA GRACE PRUSOW
5200 N DIVERSEY BLVD APT 302
WHITEFISH BAY, WI 53217-5172
Phone number: 920-889-6510
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