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Individual
MR. KEVIN S GUNDERSON
Active
Individual
MR. KEVIN S GUNDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S.E.
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5011-125
WI
101YP2500X
Professional Counselor
887-226
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100029719
—
WI
Enumeration date
08/12/2010
Last updated
09/14/2021
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