Individual
GWEN M KANDULA
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
AU.D, MBA
Contact information
Practice address
1233 N MAYFAIR RD, STE 120, MILWAUKEE, WI 53226-3255
(414) 771-6780
(414) 238-2424
Mailing address
14150 CHESTERWOOD DR, BROOKFIELD, WI 53005-2381
(414) 771-6780
(414) 238-2424
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
434 156
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41146700
—
WI
Enumeration date
02/26/2006
Last updated
07/08/2007
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