Individual
MALLORY L. GLOUDEMANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
4635 W COLLEGE AVE, APPLETON, WI 54914-8507
(920) 750-7000
(920) 364-2451
Mailing address
444 N WESTHILL BLVD, APPLETON, WI 54914-5715
(920) 750-7000
(920) 364-2451
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
5347-125
WI
Other
Enumeration date
07/21/2014
Last updated
10/13/2022
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