Individual
MS. KAREN SUE MUNDT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
C-SAC
Contact information
Practice address
132 W STATE ST, MEDFORD, WI 54451-1735
(715) 305-8112
Mailing address
132 W STATE ST, MEDFORD, WI 54451-1845
(715) 305-8112
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
11414-132
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11414-132
STATE LICENSE NUMBERS
WI
05
—
39385400
—
WI
Enumeration date
05/11/2007
Last updated
10/08/2015
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