Individual
CLARE GUSTAVSSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LP
Contact information
Practice address
777 W END AVE # 11A, NEW YORK, NY 10025-5551
(646) 327-5176
Mailing address
777 W END AVE # 11A, NEW YORK, NY 10025-5551
(646) 327-5176
Taxonomy
Speciality
Code
Description
License number
State
102L00000X
Psychoanalyst
Primary
001106
NY
Other
Enumeration date
01/04/2022
Last updated
01/04/2022
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