Individual
PATRICIA R GUSTAFSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS LP
Contact information
Practice address
MADISON EAST CENTER, STE 352, MANKATO, MN 56001
(507) 387-3195
Mailing address
PO BOX 8674, 1230 E MAIN ST, MANKATO, MN 56002-8674
(507) 625-1811
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP2298
MN
Other
Enumeration date
04/26/2006
Last updated
07/10/2020
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