Individual
LYN GORDH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
6602 GRAND TETON PLZ., STE. 100, MADISON, WI 53719-2905
(608) 828-3636
(608) 828-3637
Mailing address
6602 GRAND TETON PLZ, STE. 100, MADISON, WI 53719-1091
(608) 828-3636
(608) 828-3637
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
798-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39593700
—
WI
Enumeration date
07/31/2006
Last updated
09/19/2012
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