Organization
KAY GUSTAFSON PSYCHOLOGIST PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KAY MARIE GUSTAFSON PH.D. (OWNER)
(402) 333-8210
Entity
Organization
Contact information
Practice address
11414 W CENTER RD, SUITE 243, OMAHA, NE 68144-4486
(402) 333-8210
(402) 333-2298
Mailing address
11414 W CENTER RD, SUITE 243, OMAHA, NE 68144-4486
(402) 333-8210
(402) 333-2298
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
069
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080-66
BLUE CROSS BLUE SHIELD
NE
Enumeration date
09/16/2006
Last updated
04/20/2008
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