Individual
KAITLIN ELIZABETH GUNDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
5000 BACK SQUARE DR STE D, OWENSBORO, KY 42301-7411
(270) 685-5500
Mailing address
5000 BACK SQUARE DR STE D, OWENSBORO, KY 42301-7411
(270) 685-5500
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
258401
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
258401
LCSW
KY
Enumeration date
09/20/2023
Last updated
09/20/2023
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