Individual
GUSTAVO CARLOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
118 W 83RD ST APT B, NEW YORK, NY 10024-5018
(915) 787-0090
Mailing address
118 W 83RD ST APT B, NEW YORK, NY 10024-5018
(915) 787-0090
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
002071
NY
Other
Enumeration date
06/05/2023
Last updated
06/05/2023
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