Individual
TARA GUDEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2155 N 64TH ST, WAUWATOSA, WI 53213-2027
(865) 386-4302
Mailing address
6650 W STATE ST # 192, WAUWATOSA, WI 53213-2827
(865) 386-4302
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW84858
CA
Other
Enumeration date
03/16/2021
Last updated
05/05/2022
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