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Individual

EMILY ROSE GUSTAFSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LICSW

Contact information

Practice address
15243 NOWTHEN BLVD NW, RAMSEY, MN 55303-6138
(612) 900-0233
(866) 627-0910
Mailing address
9774 MAGNOLIA ST NW, COON RAPIDS, MN 55433-5431
(763) 807-5707

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
19227
MN

Other

Enumeration date
07/08/2025
Last updated
07/08/2025
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