Provider Demographics
NPI:1063265874
Name:PRELOG, SARA FRANCES (MSW)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:FRANCES
Last Name:PRELOG
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:197 W CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:WI
Mailing Address - Zip Code:53105-1200
Mailing Address - Country:US
Mailing Address - Phone:262-763-9191
Mailing Address - Fax:262-763-7767
Practice Address - Street 1:197 W CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:WI
Practice Address - Zip Code:53105-1200
Practice Address - Country:US
Practice Address - Phone:262-763-9191
Practice Address - Fax:262-763-7767
Is Sole Proprietor?:No
Enumeration Date:2024-04-10
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical