Amundsen, Mark Richard

Amundsen, Mark Richard is an individual health care provider with primary practice located at 5650 N Greenbay Ave , Glendale WI 53209. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Marriage & Family Therapist, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is his primary health care specialty. Amundsen, Mark Richard can be contacted via phone (262) 789-1191.

Contact Information

Primary practice address
5650 N Greenbay Ave Glendale WI 53209
Phone: (262) 789-1191
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X LH00009180 Washington
Behavioral Health & Social Service Providers / Professional 101YP2500X 4127-125 Wisconsin

Profile Details

NPI number 1053404665
LBN Legal business name Amundsen, Mark Richard
Credentials DMIN
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 2nd, 2006
Last updated Jul 14th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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