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Individual

MARSHA A GUSTAFSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
443 S 600 E, SALT LAKE CITY, UT 84102-2708
(801) 538-2057
(801) 596-2515
Mailing address
443 S 600 E, SALT LAKE CITY, UT 84102-2708
(801) 538-2057
(801) 596-2515

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5227281-6004
UT

Other

Enumeration date
01/23/2006
Last updated
07/09/2007
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