Individual
JENNIFER LYND MOSEY GUSTAFSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
6425 NICOLLET AVE, RICHFIELD, MN 55423-1675
(612) 798-8167
(612) 861-3446
Mailing address
12758 DIAMOND PATH, APPLE VALLEY, MN 55124-8375
(612) 619-6887
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
1710
MN
Other
Enumeration date
03/09/2009
Last updated
03/09/2009
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