Individual
LYNETTE C GUSTAFSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
216 CENTER ST W, ROSEAU, MN 56751-1494
(218) 463-3447
Mailing address
PO BOX 15, GREENBUSH, MN 56726-0015
(218) 688-3070
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
307243
MN
Other
Enumeration date
02/12/2025
Last updated
02/12/2025
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