Individual
MS. CYNTHIA M. GUSTAVSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.W.
Contact information
Practice address
1244 S UTICA AVE, TULSA, OK 74104-4213
(918) 295-8692
(918) 592-5789
Mailing address
1244 S UTICA AVE, TULSA, OK 74104-4213
(918) 295-8692
(918) 592-5789
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2246
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1386751485
NPI ORGANIZATION #
OK
Enumeration date
03/21/2007
Last updated
07/08/2007
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