Individual
MELISSA MARY CAROLE GUSTAVSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
110 BAKER ST STE C, WAUNAKEE, WI 53597-2707
(608) 849-5430
Mailing address
110 BAKER ST STE C, WAUNAKEE, WI 53597-2707
(608) 849-5430
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
610-228
WI
Other
Enumeration date
05/29/2018
Last updated
06/30/2022
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