Individual
MEGAN MUNDIGLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC, SAC-IT
Contact information
Practice address
1717 TAYLOR AVE, RACINE, WI 53403-2405
(262) 638-6761
Mailing address
7515 PARKVIEW RD APT 18, GREENDALE, WI 53129-2227
(414) 617-4078
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
18048-130
WI
101YM0800X
Mental Health Counselor
Primary
6992-125
WI
Other
Enumeration date
12/19/2018
Last updated
12/19/2018
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