Doctor Name: | MS. KATE MARIE GUNDERSEN |
NPI Number: | 1770812265 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MSW, LCSW |
License Number: | 5192 |
Business Practice Address: | 15260 Sewanee Highway Sewanee, TN - 37375 |
Business Phone Number: | 9312354498 |
Business Fax Number: | 9315923333 |
Mailing Address: | P.o. Box 1316, MONTEAGLE |
State: | TN |
Postal Code: | 37356 |
Phone Number: | 9312354498 |
Fax Number: | 9315923333 |
NPI Enumeration Date: | 12/14/2009 |
NPI Last Update Date: | 03/17/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 5192 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |