Individual
MARY GUSTAFIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
312 S FIRST AVE LOWR LEVEL, SANDPOINT, ID 83864-1202
(208) 263-7727
(208) 263-7728
Mailing address
202 E ANTON AVE STE 206, COEUR D ALENE, ID 83815-3779
(208) 667-6095
(208) 667-6173
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
3849
ID
Other
Enumeration date
10/29/2007
Last updated
10/29/2007
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