Individual
AMANDA GAUGLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1802 S MATTIS AVE, CHAMPAIGN, IL 61821-5923
(217) 365-2855
(217) 365-2856
Mailing address
611 W PARK ST, URBANA, IL 61801-2529
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
IL
1041C0700X
Clinical Social Worker
Primary
149024034
IL
Other
Enumeration date
02/26/2016
Last updated
05/19/2022
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