Organization
EILEEN GUSTAFSON LCSW PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. EILEEN GUSTAFSON LCSW (OWNER/THERAPIST)
(352) 428-8463
Entity
Organization
Contact information
Practice address
10335 CROSS CREEK BLVD, SUITE 23, TAMPA, FL 33647-2795
(352) 428-8463
(352) 597-2074
Mailing address
PO BOX 5797, SPRING HILL, FL 34611-5797
(352) 428-8463
(352) 597-2074
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
LCSW 6283
FL
Other
Enumeration date
10/12/2007
Last updated
08/12/2008
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