Individual
KANDIS GALLENTINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
8500 221ST AVE, SALEM, WI 53168-9351
(262) 995-8352
Mailing address
8500 221ST AVE, SALEM, WI 53168-9351
(262) 995-8352
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
11230-123
WI
Other
Enumeration date
05/24/2023
Last updated
05/24/2023
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