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Individual

HOLLIS WUNDERLICH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPCC

Contact information

Practice address
122 CENTRAL AVE N, FARIBAULT, MN 55021
(507) 491-4848
(507) 323-8141
Mailing address
PO BOX 431, FARIBAULT, MN 55021-0431

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CC01537
MN
103TC1900X
Counseling Psychologist
CC01537
MN

Other

Enumeration date
06/09/2017
Last updated
01/04/2019
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