Individual
HEATHER LYNN GUSTAFSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
1400 JACKSON ST, DENVER, CO 80206-2761
(303) 388-4461
(303) 270-2174
Mailing address
1400 JACKSON ST, DENVER, CO 80206-2761
(303) 388-4461
(303) 270-2174
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
0011
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001
MASTERS OF ART UC
CO
Enumeration date
11/21/2006
Last updated
07/08/2007
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