| Doctor Name: | MR. LESLIE HAROLD PRAUSA |
| NPI Number: | 1003942632 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LPC, CADC III |
| License Number: | 10303-132 |
| Business Practice Address: | 12425 Knoll Rd Suite 110 Elm Grove, WI - 531222657 |
| Business Phone Number: | 2627809788 |
| Business Fax Number: | 2624320045 |
| Mailing Address: | 447 Coolidge St, OCONOMOWOC |
| State: | WI |
| Postal Code: | 530662807 |
| Phone Number: | 2628933331 |
| Fax Number: | 2624320045 |
| NPI Enumeration Date: | 02/26/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 10303-132 |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | WI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |