Individual
ANDREA GUSTAFSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3115 DOUGLAS AVE, DES MOINES, IA 50310-5307
(515) 235-4720
Mailing address
3125 DOUGLAS AVE, DES MOINES, IA 50310-5365
(515) 235-4720
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
007089
IA
Other
Enumeration date
02/05/2009
Last updated
09/30/2013
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