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Individual

HEATHER M AMUNDSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CAPSW

Contact information

Practice address
202 S PARK ST, PATIENT & FAMILY SERVICES, MADISON, WI 53715-1507
(608) 417-6027
Mailing address
202 S PARK ST, PATIENT & FAMILY SERVICES, MADISON, WI 53715-1507
(608) 417-6027

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
127613-121
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
15649-130
STATE OF WISCONSIN
WI
Enumeration date
04/06/2009
Last updated
04/06/2009
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