Individual
DR. HOLLY BETH GUSTAFSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1169 EASTERN PKWY, STE 431, LOUISVILLE, KY 40217-1417
(502) 212-1032
(502) 212-1033
Mailing address
1169 EASTERN PKWY, STE 431, LOUISVILLE, KY 40217-1417
(502) 212-1032
(502) 212-1033
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
736
KY
Other
Enumeration date
01/04/2007
Last updated
07/08/2007
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