Individual
JENNIFER GUSTAVSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
107 NORTHRUP DR, BRICK, NJ 08724-2021
(732) 614-9635
Mailing address
107 NORTHRUP DR, BRICK, NJ 08724-2021
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
44SC05509200
NJ
Other
Enumeration date
09/24/2012
Last updated
03/04/2026
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