Prom, Tara M

Prom, Tara M is an individual health care provider with primary practice located at 22 Wilson Ave Ne Suite 110 Po Box 6069, Saint Cloud MN 56302-6069. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / School. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Prom, Tara M can be contacted via phone (320) 251-7700.

Contact Information

Primary practice address
22 Wilson Ave Ne Suite 110 Po Box 6069 Saint Cloud MN 56302-6069
Phone: (320) 251-7700
Fax: (320) 251-8898
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 17338 Minnesota
Behavioral Health & Social Service Providers / School 101YS0200X 429597 Minnesota

Profile Details

NPI number 1205338969
LBN Legal business name Prom, Tara M
Credentials LICSW
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 8th, 2018
Last updated Mar 8th, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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