Individual
MRS. PATRICIA ANN GUNDRUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW,LMSW
Contact information
Practice address
3493 WOODS EDGE, SUITE 103, OKEMOS, MI 48864-5911
(517) 886-3707
(517) 349-1973
Mailing address
PO BOX 43, MASON, MI 48854-0043
(517) 623-6260
(517) 623-6460
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6801073024
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
800313060
BLUE CROSS BLUE SHIELD OF MICHIGAN
MI
Enumeration date
04/30/2009
Last updated
02/09/2011
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