Organization
LIZ GUSTAFSON PSYCHOTHERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH GUSTAFSON (CLINICAL PSYCHOLOGIST, PRESIDENT)
(323) 963-3335
Entity
Organization
Contact information
Practice address
450 N BRAND BLVD STE 600, GLENDALE, CA 91203-2349
(323) 963-3335
Mailing address
450 N BRAND BLVD STE 600, GLENDALE, CA 91203-2349
(323) 963-3335
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
07/05/2018
Last updated
07/05/2018
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