Provider Demographics
NPI:1699272047
Name:PROZELLER, KATHERINE M (PSYD, MA, MBA)
Entity type:Individual
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First Name:KATHERINE
Middle Name:M
Last Name:PROZELLER
Suffix:
Gender:F
Credentials:PSYD, MA, MBA
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Other - Middle Name:
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Mailing Address - Street 1:8731 ALVERNO AVE
Mailing Address - Street 2:
Mailing Address - City:INVER GROVE HEIGHTS
Mailing Address - State:MN
Mailing Address - Zip Code:55077-3531
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2501 HANLEY RD
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:WI
Practice Address - Zip Code:54016-8705
Practice Address - Country:US
Practice Address - Phone:715-381-1980
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-11
Last Update Date:2018-04-11
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health