Provider Demographics
NPI:1093216475
Name:PROCHNOW, STEVIE DAWN (OTR, CLT)
Entity Type:Individual
Prefix:MRS
First Name:STEVIE
Middle Name:DAWN
Last Name:PROCHNOW
Suffix:
Gender:F
Credentials:OTR, CLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6606 VISTA VALLEY
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:WI
Mailing Address - Zip Code:53598-9120
Mailing Address - Country:US
Mailing Address - Phone:608-347-3738
Mailing Address - Fax:
Practice Address - Street 1:600 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53792-0001
Practice Address - Country:US
Practice Address - Phone:608-263-6400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-22
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6220-026225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist