| Doctor Name: | DR. NATHANIEL WILLIAM GUMP |
| NPI Number: | 1265714133 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PH.D. |
| License Number: | 2738-57 |
| Business Practice Address: | 1881 Chicago St De Pere, WI - 541153770 |
| Business Phone Number: | 9204038000 |
| Business Fax Number: | |
| Mailing Address: | 1365 Pinehurst Ln, NEENAH |
| State: | WI |
| Postal Code: | 549564452 |
| Phone Number: | 9794920586 |
| Fax Number: | |
| NPI Enumeration Date: | 09/15/2011 |
| NPI Last Update Date: | 02/20/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC1900X |
| License Number: | 2738-57 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Counseling |
| Taxonomy Definition: | |