Provider Demographics
NPI:1477359263
Name:SINGH, PRABHNOOR
Entity type:Individual
Prefix:
First Name:PRABHNOOR
Middle Name:
Last Name:SINGH
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 GRANT ST # 1802
Mailing Address - Street 2:
Mailing Address - City:DE PERE
Mailing Address - State:WI
Mailing Address - Zip Code:54115-2002
Mailing Address - Country:US
Mailing Address - Phone:920-378-5965
Mailing Address - Fax:
Practice Address - Street 1:1433 N WATER ST STE 400
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53202-2603
Practice Address - Country:US
Practice Address - Phone:920-378-5965
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-21
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst