Organization
COLLABORATIVE PSYCHOTHERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TERENCE MICHAEL GUNVILLE LCSW (PSYCHOTHERAPIST)
(414) 292-3900
Entity
Organization
Contact information
Practice address
6793 N GREEN BAY AVE, GLENDALE, WI 53209-3422
(414) 292-3900
(414) 292-3901
Mailing address
8961 W PALMETTO CT, MILWAUKEE, WI 53225-5017
(414) 536-8604
(414) 536-8605
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
835-123
WI
Other
Enumeration date
05/07/2012
Last updated
05/07/2012
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