Provider Demographics
NPI:1477910651
Name:WUNDELER, ALISON AMY
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:AMY
Last Name:WUNDELER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ALISON
Other - Middle Name:AMY
Other - Last Name:WUNDELER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:149 PARTRICK AVE
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06851-2620
Mailing Address - Country:US
Mailing Address - Phone:914-584-2268
Mailing Address - Fax:
Practice Address - Street 1:149 PARTRICK AVE
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06851-2620
Practice Address - Country:US
Practice Address - Phone:914-584-2268
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-20
Last Update Date:2016-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT89471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical