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Individual

MS. KATHRYN M BUNGE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LISW

Contact information

Practice address
518 S 8TH ST, SUITE #207, CLEAR LAKE, IA 50428-2577
(641) 357-0272
(641) 357-3059
Mailing address
518 S 8TH ST, SUITE #207, CLEAR LAKE, IA 50428-2577
(641) 357-0272
(641) 357-3059

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
00173
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
04645
WELLMARK BLUE SHIELD
IA
01
21957
MIDLANDS
IA
Enumeration date
02/01/2006
Last updated
10/08/2012
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