Individual
HALEY MARIE GUSTAVSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
30 AVON MEADOW LN, AVON, CT 06001-3745
(860) 284-9779
(860) 409-4120
Mailing address
30 AVON MEADOW LN, AVON, CT 06001-3745
(860) 284-9779
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
006209
CT
Other
Enumeration date
07/17/2020
Last updated
07/17/2020
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