Individual
JENNIFER HELEN GUSTAFSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
45 PORTLAND RD STE 71037, KENNEBUNK, ME 04043-6660
(207) 358-9422
Mailing address
45 PORTLAND RD STE 71037, KENNEBUNK, ME 04043-6660
(207) 358-9422
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
OT2570
ME
225XP0200X
Pediatric Occupational Therapist
Primary
—
—
Other
Enumeration date
11/24/2012
Last updated
01/22/2024
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