Individual provider · Type 1 NPI
Mark Richard Amundsen, DMIN
Professional Counselor · Glendale, WI
NPI number
1053404665
Active
Practice location
5650 N Greenbay Ave
Glendale, WI 53209
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Marriage & Family Therapist | 106H00000X | LH00009180 (WA) |
| Professional Counselor Primary | 101YP2500X | 4127-125 (WI) |
Professional Counselor: Definition to come...
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About NPI 1053404665
Mark Richard Amundsen, DMIN's National Provider Identifier is 1053404665, issued on Oct 2, 2006. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Glendale, WI. The record was last updated on Jul 14, 2022.