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Individual
MRS. KERRY ANN GUNDLACH
Active
Individual
MRS. KERRY ANN GUNDLACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RD, LD
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
001949
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001949
IDPH/PROFESSIONAL LICENSURE BUREAU
IA
Enumeration date
01/20/2017
Last updated
01/20/2017
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