Individual
JESSE GUNDACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW
Contact information
Practice address
514 RIVERVIEW AVE, WAUKESHA, WI 53188-3631
(262) 548-7666
Mailing address
1071 REGENT RD. APT 708, OCONOMOWOC, WI 53066
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
134821-121
WI
Other
Enumeration date
10/05/2022
Last updated
08/22/2024
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