Individual
JESSICA MAREE GUSTAFSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1722 E SPRAGUE AVE STE 214, SPOKANE, WA 99202-3109
(509) 505-9614
Mailing address
1722 E SPRAGUE AVE STE 214, SPOKANE, WA 99202-3109
(509) 505-9614
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/17/2019
Last updated
06/01/2024
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