Individual
MARIA GUSTIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 GREENBRIAR ROAD, POTTSVILLE, PA 17901
(570) 622-9595
Mailing address
100 GREENBRIAR RD, POTTSVILLE, PA 17901-4013
(570) 622-9595
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
PA
103K00000X
Behavior Analyst
Primary
BH000142
PA
Other
Enumeration date
07/22/2014
Last updated
07/23/2014
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