Individual
ANGELA GUNDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
36100 GENESEE LAKE RD, OCONOMOWOC, WI 53066-9201
(262) 468-0629
Mailing address
PO BOX 278, DOUSMAN, WI 53118-0278
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
10372-120
WI
Other
Enumeration date
12/19/2013
Last updated
12/19/2013
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