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Individual
WAYNE ERIC GUSTAFSON
Active
Individual
WAYNE ERIC GUSTAFSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.MIN.
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LMHC 002006
NY
101YP1600X
Pastoral Counselor
—
—
Other
Enumeration date
04/29/2015
Last updated
04/29/2015
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