Individual
CHRISTINE P GUSTUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW/LCSW
Contact information
Practice address
110 SKYLINE DRIVE, RUSSELLVILLE, AR 72801-2601
(479) 968-1298
(479) 890-5364
Mailing address
110 SKYLINE DRIVE, RUSSELLVILLE, AR 72801-2601
(479) 968-1298
(479) 890-5364
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1063-C
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5S875
AR BCBS
AR
Enumeration date
09/06/2006
Last updated
04/29/2014
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