Individual
PETER JOSEPH VANDUSARTZ III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
405 STAGELINE RD, HUDSON, WI 54016-7848
(612) 396-6313
Mailing address
405 STAGELINE RD, HUDSON, WI 54016-7848
(612) 396-6313
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3882-123
WI
Other
Enumeration date
10/23/2023
Last updated
10/23/2023
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