Individual
GUSTAVO MARCELO CONGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PPS, LEP
Contact information
Practice address
1970 FURLOW DR, REDLANDS, CA 92374-1646
(909) 329-4264
Mailing address
PO BOX 8124, REDLANDS, CA 92375-1324
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
4334
CA
Other
Enumeration date
02/19/2024
Last updated
02/19/2024
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