Individual
MS. ANDREA L. GUSTAFSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.C.S.W., L.M.T.
Contact information
Practice address
1808 FOLSOM ST, EAU CLAIRE, WI 54703-2579
(715) 404-9031
Mailing address
1010 PUMPHOUSE RD, UNIT C, CHIPPEWA FALLS, WI 54729-4041
(715) 861-3108
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
7649-123
WI
225700000X
Massage Therapist
4982-146
WI
Other
Enumeration date
05/27/2007
Last updated
11/10/2010
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