Mrs. Tara M Prom
School Counselor Clinical Social Worker
22 Wilson Ave Ne Suite 110 Po Box 6069
Saint Cloud
, Minnesota 56302-6069
Mrs. Tara M Prom
School Counselor Clinical Social Worker
22 Wilson Ave Ne Suite 110 Po Box 6069
Saint Cloud
, Minnesota 56302-6069
(320) 266-0241
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About
Features
Specialties
- School Counselor
- Clinical Social Worker
Languages spoken
- English
Location
First Address
- Mrs. Tara M Prom
- 1114 Somerset Blvd
- Saint Cloud, MN
- Zip : 56303-0750
- Phone : (320) 266-0241
Second Address
- Mrs. Tara M Prom
- 22 Wilson Ave Ne Suite 110 Po Box 6069
- Saint Cloud, MN
- Zip : 56302-6069
- Fax : (320) 251-8898
- Phone : (320) 251-7700
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 101YS0200X | School Counselor | 429597 | MN |
| Y | 1041C0700X | Clinical Social Worker | 17338 | MN |
National Provider Identifier
| NPI | 1205338969 |
|---|---|
| Provider Name | Mrs. Tara M Prom |
| First Address | Saint Cloud, MN 56303-0750 |
| Second Address | Saint Cloud, MN 56302-6069 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 08/03/2018 |
| Last Update Date | 08/03/2018 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.